覆膜支架腔内修复内脏动脉瘤和假性动脉瘤的应用  

Application of Endovascular Covered Stent Graft Repair of Visceral Artery Aneurysms and Pseudoaneurysms

作　　者：明志兵[1] 于晓强[1] 夏春秋[1] 梁火奇 仲崇俊[1] MING Zhibing;YU Xiaoqiang;XIA Chunqiu;LIANG Huoqi;ZHONG Chongjun(Department of Vascular Surgery,Second Affiliated Hospital,Nantong University,Nantong 226001,China)

机构地区：[1]南通大学第二附属医院血管外科,江苏南通226001

出　　处：《中国医学影像学杂志》2020年第10期798-F0003,共4页Chinese Journal of Medical Imaging

基　　金：南通市科技项目(MS12018056);南通市医学重点人才项目(重点12);江苏省“六大人才高峰”高层次人才项目(WSN-269)。

摘　　要：目的探讨覆膜支架腔内修复内脏动脉瘤(VAA)和假性动脉瘤(VAPA)的疗效和安全性。资料与方法回顾性分析采用覆膜支架腔内治疗18例VAA和10例VAPA的临床资料,穿刺股动脉或肱动脉途径,造影评估动脉瘤的部位、大小、载瘤动脉直径,长鞘保护和定位下行覆膜支架腔内隔绝,复杂病例采用瘤腔内成襻技术通过瘤腔,术后造影评估疗效,并行CT血管成像随访,观察技术和临床成功率、围术期并发症、术后未再干预率、支架通畅率及瘤腔隔绝情况。结果27例VAA和VAPA成功行覆膜支架腔内隔绝术,技术成功率为96.4%(27/28),临床成功率为85.7%(24/28),围术期并发症发生率为3.6%(1/28),覆膜支架置入后未再干预率为88.9%(24/27)。术后6个月随访支架通畅率为96.3%(26/27),动脉瘤获完全隔绝率为100.0%(27/27),术后12个月和2年随访动脉瘤获完全隔绝率为100.0%,支架通畅率为92.6%(25/27)。结论覆膜支架可腔内修复VAA和VAPA,瘤腔隔绝完全,载瘤动脉通畅,临床疗效确切,安全有效。Purpose To investigate the clinical efficacy and safety of endovascular covered stent in the repair of visceral artery aneurysms(VAA)and visceral artery pseudoaneurysms(VAPA).Materials and Methods Eighteen patients with VAA and 10 patients with VAPA who underwent endovascular covered stent were retrospectively analyzed.The femoral artery or brachial artery was used for angiography of the targeted vessel for evaluation of the location and size of the aneurysm and the diameter of the aneurysm-bearing artery.Under the protection and accurate position of long sheath,endovascular treatmeat with endovascular covered stent was performed.Intra-aneurysmal microcatheter looping technique was used in the setting of complex cases,postoperative angiography was used to evaluate the efficacy,and CTA was used to follow up.The technique success rate,clinical success rate,perioperative complications,postoperative reintervention rate,stent patency rate and aneurysmal isolation rate were observed.Results Endovascular covered stent graft repair was successfully fullfilled in 27 cases of patients with VAA and VAPA.The technical success rate was 96.4%(27/28),the clinical success rate was 85.7%(24/28).The perioperative complication rate was 3.6%(1/28),and postoperative reintervention rate was 88.9%(24/27).Six months after operation,the stent patency rate was 96.3%(26/27),and the complete isolation rate of aneurysm was 100.0%(27/27),while at 12 and 24 months after operation,the complete isolation rate of aneurysms was 100.0%,and the stent patency rate was 92.6%(25/27).Conclusion endovascular covered stent can repair VAA and VAPA intraluminally,the tumor cavity is completely isolated,the tumor-carrying artery is unobstructed,the clinical effect is accurate,safe and effective.

关 键 词：动脉瘤 动脉瘤 假性 腔内治疗 覆膜支架 治疗结果 

分 类 号：R732.2[医药卫生—肿瘤]