腔内治疗锁骨下动脉瘤  

Endovascular Treatment of Subclavian Artery Aneurysm

作　　者：赵昱博 化召辉[1] 焦周阳[1] 曹辉[1] 徐鹏[1] 刘仕睿 李震[1] ZHAO Yubo;HUA Zhaohui;JIAO Zhouyang;CAO Hui;XU Peng;LIU Shirui;LI Zhen(Department of Endovascular Surgery,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院腔内血管外科,河南郑州450052

出　　处：《河南医学研究》2021年第13期2350-2353,共4页Henan Medical Research

摘　　要：目的观察腔内治疗锁骨下动脉瘤(SAA)的效果与随访结果。方法收集郑州大学第一附属医院腔内血管外科于2013年1月至2019年12月收治的17例接受腔内治疗的SAA患者的临床资料,回顾性分析患者的一般资料、腔内治疗和随访结果。结果17例患者均成功接受腔内治疗,1例行覆膜支架植入和右椎动脉-颈总动脉移位,1例行瘤腔弹簧圈栓塞,1例行裸支架辅助下弹簧圈栓塞,2例行密网支架植入,11例行覆膜支架植入(其中2例联合Wallstent),1例行覆膜支架植入联合弹簧圈栓塞。中位随访时间为2 a,3例支架闭塞,2例于密网支架术后出现Ⅰ型内漏,1例随访1 a内漏仍存在,1例随访5 a内漏消失,1例术后1个月因Ⅱ型内漏瘤体增大破入气管死亡,1例术后1 a发生Ⅲ型夹层行腔内修复。结论腔内治疗SAA成功率高,创伤小,并发症发生率低,近中期通畅率满意,可作为SAA首选治疗方式。对于瘤体较大者,建议行瘤腔和分支动脉栓塞,确保手术效果。Objective To observe the effect and follow-up results of endovascular treatment of subclavian artery aneurysm(SAA).Methods The clinical data of 17 patients with SAA who received endovascular treatment in the Department of Endovascular Surgery of the First Affiliated Hospital of Zhengzhou University from January 2013 to December 2019 were collected.The general data,endovascular treatment and follow-up results of the patients were retrospectively analyzed.Results All the 17 patients were treated with endovascular treatment successfully.One case underwent covered stent implantation and right vertebral artery-common carotid artery transposition.One case received coil embolization.One case was treated with bare stent-assisted coil embolization.Two cases were treated with dense mesh stent implantation.Eleven cases received covered stent implantation,including 2 cases combined with Wallstent.One case was treated with covered stent implantation combined with coil embolization.The median follow-up time was 2 years.Stent occlusion occurred in 3 cases.TypeⅠendoleak occurred in 2 cases after dense mesh stent implantation,and 1 case still existed endoleak within one year of follow-up,and the endoleak disappeared in 1 case within 5 years of follow-up.One case died because the tumor of typeⅡinternal leakage enlarged and ruptured into trachea after one month.One case underwent endovascular repair because of typeⅢdissection one year after operation.Conclusion Endovascular treatment of SAA has the high success rate,less trauma,low complication rate and satisfactory patency in the near and medium term,which can be used as as the first choice for the treatment of SAA.For patients with large aneurysm,embolization of tumor cavity and branch artery is recommended to ensure the effect of operation.

关 键 词：锁骨下动脉瘤 腔内治疗 支架 栓塞 

分 类 号：R654.3[医药卫生—外科学]