腔内修复联合开窗技术治疗主动脉弓部病变  

Endovascular repair combined with fenestrated stent grafts in treating aortic arch lesions

作　　者：高文韬 周敏[1] 杨光敏 麦合木提江•穆扎帕 张明[1] 王炜[1] 黄佃[1] 李晓强 Gao Wentao;Zhou Min;Yang Guangmin;Maihemutijiang•Miizhapa;Zhang Ming;Wang Wei;Huang Dian;Li Xiaoqiangi(Department of Vascular Surgery,Nanjing Drum Touer Hospital,Nanjing University of Medical School,Nanjing 210009,China)

机构地区：[1]南京大学医学院附属鼓楼医院血管外科,南京210009

出　　处：《中华胸心血管外科杂志》2019年第12期739-743,共5页Chinese Journal of Thoracic and Cardiovascular Surgery

摘　　要：目的探讨主动脉腔内修复手术联合开窗支架技术治疗累及主动脉弓部的夹层或动脉瘤疗效。方法回顾性分析2017年6月至2018年12月,应用开窗技术重建主动脉弓分支血管技术治疗的30例复杂主动脉弓病变患者,男26例,女4例;年龄(53±16)岁;均有高血压史。30例患者中,采用原位开窗技术12例,支架体外预开窗技术16例,原位与体外联合开窗2例。术后随访,行CT血管造影。结果30例患者手术成功率100%。随访中位时间8.5个月,无患者死亡。大面积脑梗塞、心包积液各1例,Ⅲ型内漏5例,未再次干预。随访期间,患者靶血管均通畅。结论对累及主动脉弓部病变的患者采用开窗支架技术治疗短期效果良好。Objective To evaluate endovascular repair combined with fenestrated stent grafts for the treatment of aortic dissection or aneurysm involving aortic arch.Methods From Jun 2017 to Dec 2018,30 patients of complicated aortic arch lesions were treated with endovascular repair combined with fenestrated endografts.26 male and 4 female,aged(53±16)years.All patients had hypertension.12 cases were treated via needle based in situ fenestration,another 16 cases using physician modified stent grafts,while 2 cases combining these two methods to achieve optimal fenestration.Patients were followed by receiving CTA for mortality,patency of bridging stents,endoleaks and complications.Results Operations were performed successfully in all cases.The median follow-up is 8.5 months.There was no aorta-related mortality.1 patient developed cerebral infarction and 1 had hydropericardium.TypeⅢendoleaks were observed in 5 patients,no reintervention.All target vessels were patent during the follow up.Conclusion Fenestrated stent grafts shows satisfactory short-term outcomes in treating aortic arch lesions.

关 键 词：主动脉弓 TEVAR 开窗支架 

分 类 号：R65[医药卫生—外科学]