杂交手术及腔内修复术治疗Kommerell憩室的疗效分析  

Efficacy analysis of hybrid procedures or endovascular repair for Kommerell diverticulum

作　　者：李鹏[1] 王吉阳[1] 陈作观 刁永鹏[1] 李拥军[1] Li Peng;Wang Jiyang;Chen Zuoguan;Diao Yongpeng;Li Yongjun(Department of Vascular Surgery,Beijing Hospital/National Center of Gerontology/Institute of Geriatric Medicine,Chinese Academy of Medical Sciences,Beijing 100730,China)

机构地区：[1]北京医院/国家老年医学中心/中国医学科学院老年医学研究院血管外科,北京100730

出　　处：《血管与腔内血管外科杂志》2022年第3期258-262,共5页Journal of Vascular and Endovascular Surgery

基　　金：北京医院临床研究121工程(BJ-2018-089)。

摘　　要：目的探讨杂交手术及腔内修复术治疗Kommerell憩室(KD)的安全性及有效性。方法收集2016年10月至2021年12月北京医院收治的4例KD患者的临床资料,分析患者的主动脉弓变异情况、手术方式、围手术期与随访情况。结果4例患者中2例行腔内手术,2例行杂交手术,手术成功率100%。手术时间90~240 min,平均(152±64)min。术后即时造影显示支架及各分支显影良好,所有患者术后临床症状明显改善,围手术期无神经系统及上肢缺血并发症。随访3个月~5年,所有患者均生存,无支架移位,无内漏。结论腔内修复术治疗KD创伤小、术后恢复快,并且可处理大部分的KD病变。是否采取杂交手术取决于病变近端的锚定区大小,因此,根据不同病例特点采取个体化治疗是成功的关键。Objective To investigate the safety and efficacy of hybrid surgery and endovascular repair surgery for Kommerell diverticulum(KD).Method The clinical data of 4 patients with KD admitted to Beijing Hospital from October 2016 to December 2021 were collected,the aortic arch variation,surgical methods,perioperative period and follow-up of the patients were summarized.Result Among the 4 patients,2 underwent endovascular repair and 2 underwent hybrid surgery,with a success rate of 100%.The operation time ranged from 90 to 240 minutes,the an average of(152±64)min.Postoperative immediate angiography showed that the stent and all branches were well visualized.The clinical symptoms of all patients were significantly improved after the operation,and there were no complications of the nervous system and upper limb ischemia during the perioperative period.The follow-up range from 3 month to 5 years,and all patients survived without stent displacement and endoleak.Conclusion Endovascular repair surgery could treat most KD lesions with less invasive and quicker postoperative recovery.Whether hybrid surgery depends on the size of the anchoring zone at the proximal end of the lesion.Therefore,it is vital to employ individualized treatment according to the characteristics of different cases.

关 键 词：Kommerell憩室 腔内修复术 杂交手术 血管畸形 

分 类 号：R543[医药卫生—心血管疾病]