分支胸主动脉腔内修复技术重建左锁骨下动脉治疗复杂主动脉弓部病变的近期结果  

Short-term results of left subclavian artery reconstruction with branched thoracic endovascular aortic repair in the treatment of complex aortic arch lesions

作　　者：潘红瑞 罗光泽 罗宇东[1] 范海伦[1] 冯舟[1] 朱杰昌[1] 张益伟[1] 胡凡果[1] 戴向晨[1] Pan Hongrui;Luo Gangze;Luo Yudong;Fan Hailun;Feng Zhou;Zhu Jiechang;Zhang Yiwei;Hu Fanguo;Dai Xiangchen(Depatrment of Vascular Surgery,Tianjin Medical University General Hospital,Tianjin 300052,China)

机构地区：[1]天津医科大学总医院普通外科,300052

出　　处：《中华普通外科杂志》2019年第10期874-878,共5页Chinese Journal of General Surgery

基　　金：天津市科技支撑重点项目(16YFZCSY01080).

摘　　要：目的评估分支TEVAR技术治疗复杂主动脉弓部病变的近期疗效.方法回顾性分析天津医科大学总医院2016年4月至2018年12月应用分支TEVAR技术治疗的18例需重建左锁骨下动脉的主动脉病变患者的围手术期及随访资料.结果置入Castor外分支支架16例,自制内分支支架2例,器械释放成功率100%,手术成功率100%,无术中死亡病例.术后并发症2例:支架近端逆撕夹层1例(行开放手术)、大面积心梗1例(死亡).17例患者获得随访,随访时间1~8个月.术后第30天16例CTA检查1例发生Ⅲ型内漏,分支支架血流通畅.术后6个月8例CTA检查无内漏,1例左锁骨下动脉支架远端闭塞,予远端置入支架解决,无新发死亡病例.结论分支TEVAR技术是重建弓上分支动脉的有效方法.Objective To evaluate the short-term efficacy of branched TEVAR in the treatment of complex aortic arch lesions.Methods The clinical data of 18 patients with aortic lesions requiring reconstruction of the left subclavian artery who were treated with branch TEVAR technology in Tianjin Medical University General Hospital from Apr 2016 to Dec 2018 were analyzed retrospectively.Results There were 16 cases using Castor external branch stent implantation and 2 cases of self-made internal branch stent.The success rate of device release was 100%,the success rate of operation was 100%,and there were no intraoperative deaths.Postoperative complications occurred in 2 cases:one proximal stent tear dissection required open surgery,one died of massive myocardial infarction.Seventeen patients were followed up for 1-8 months.CTA examination in 16 patients 30 days after surgery,found 1 patient with type Ⅲ endoleak.CTA examination done in 8 patients 6 months after surgery found distal occlusion of left subclavian artery stent in 1 patient necessitating distal stent implantation.Conclusion The branch TEVAR technique is effective method to reconstruct the arch branched artery.

关 键 词：主动脉疾病 锁骨下动脉 胸主动脉腔内修复术 分支支架 

分 类 号：R65[医药卫生—外科学]