一体式分叉型覆膜支架在腹主动脉病变腔内修复中的应用  

Clinical applic ation of unibody bifurcated covered-stent in endovascular aortic repair of abdominal aortic lesions

作　　者：刘家成 熊斌[1] 周晨 马金强 石钦 袁锋[1] 熊付[1] 阚雪锋[1] 郑传胜[1] LIU Jiacheng;XIONG Bin;ZHOU Chen;MA Jinqiang;SHI Qin;YUAN Feng;XIONG Fu;KAN Xuefeng;ZHENG Chuansheng(Department of Radiology,Affiliated Union Hospital,Tongji Medical College,Huazhong University of Science and Technology,Hubei Provincial Key Laboratory of Molecular Imaging,Wuhan,Hubei Province 430022,China)

机构地区：[1]华中科技大学同济医学院附属协和医院放射科分子影像湖北省重点实验室

出　　处：《介入放射学杂志》2019年第8期734-737,共4页Journal of Interventional Radiology

摘　　要：目的探讨一体式分叉型覆膜支架腔内修复腹主动脉病变的安全性、有效性及适合人群。方法回顾性分析2016年8月至2018年10月采用一体式分叉型覆膜支架行腔内修复术治疗的11例腹主动脉病变患者临床资料,其中腹主动脉夹层伴髂总动脉夹层4例(36.4%),腹主动脉瘤2例(18.2%),腹主动脉壁内血肿伴髂总动脉夹层、腹主动脉溃疡伴髂总动脉闭塞、髂总动脉夹层、腹主动脉瘤伴髂总动脉瘤、髂总动脉瘤各1例。评估手术治疗效果,术后支架变形、移位及内漏,支架内血流通畅情况,观察术后并发症。结果11例患者腔内修复术均获成功,围手术期未出现严重并发症。术后3、6个月无支架变形或移位发生,支架内血流通畅率均为100%,无一例死亡。术后3个月发现Ⅰ型内漏1例,术后6个月复查时消失。术后1个月1例出现心力衰竭,入院治疗后好转。结论一体式分叉型覆膜支架治疗腹主动脉病变安全有效,对入路血管损伤小、支架无移位,适合于治疗局限性腹主动脉夹层、主髂分叉处直径较小的腹主动脉瘤等病变。Objective To discuss the efficacy,safety and suitable population of the use of unibody bifurcated covered-stent in endovascular aortic repair(EVAR) of abdominal aortic lesions.Methods The clinical data of 11 patients with abdominal aortic disease,who received EVAR with unibody bifurcated covered- stent during the period from August 2016 to October 2018,were retrospectively analyzed.The lesio ns included abdominal aortic dissection associated with common iliac artery dissection (n=4,36.4%),abdominal aortic aneurysm(n=2,18.2%),hematoma in abdominal aorta wall with common iliac artery dissection (n=1,9.1%), abdominal aortic ulcer with occlusion of common iliac artery (n=1,9.1%),common iliac artery dissection (n=1,9.1%), abdominal aortic aneurysm complicated by common iliac aneurysm (n=1,9.1%),and common iliac aneurysm (n=1,9.1%).The curative effect of EVAR,stent deformation,stent displacement,endoleak,and the patency of blood flow in stent were assessed,the postoperative complications were recorded.Results Successful EVAR was accmplished in all 11 patients,and no severe perioperative complications occurred.At 3 months and 6 months after EVAR,no stent deformation or displacement was observed and the patency rate of blood flow in stent was 100%,and no death occurred.One patient developed type I endoleak in 3 months after EVAR,which disappeared in follow- up reexamination at 6 months after EVAR.One patient developed heart failure one month after EVAR,which was improved after the patient was admitted to receive treatment.Conclusion In treating abdominal aortic lesions with EVAR,the use of unibody bifurcated covered- stent is safe and effect. This technique has little damage to the approach vessels and the stent will not be displaced,therefore,it is suitable for localized abdominal aortic dissection as well as for the small abdominal aortic aneurysms located at the aortic-iliac bifurcation.

关 键 词：一体式分叉型覆膜支架 血管内修复 腹主动脉夹层 解剖固定 

分 类 号：R543[医药卫生—心血管疾病]