可控弹簧圈结合普通弹簧圈栓塞治疗胸主动脉夹层开窗支架腔内修复术后内漏  

Controllable coil combined with common coil embolization for the treatment of endoleak occurring after endovascular fenestration/stenting of thoracic aortic dissection

作　　者：刘昭[1] 金怡 唐涛 童垣皓 刘晨[1] 乔彤[1] 周敏[1] 于同[1] 王炜[1] 张明[1] 冉峰[1] 刘长建[1] 李晓强 LIU Zhao;JIN Yi;TANG Tao;TONG Yuanhao;LIU Chen;QIAO Tong;ZHOU Min;YU Tong;WANG Wei;ZHANG Ming;RAN Feng;LIU Changjian;LI Xiaoqiang(Department of Vascular Surgery,Affiliated Drum Tower Hospital,Medical School of Nanjing University,Nanjing,Jiangsu Province 210008,China)

机构地区：[1]南京大学医学院附属鼓楼医院血管外科,210008

出　　处：《介入放射学杂志》2022年第6期560-564,共5页Journal of Interventional Radiology

摘　　要：目的 评价应用可控弹簧圈结合普通弹簧圈栓塞技术治疗胸主动脉夹层开窗支架胸主动脉腔内修复术(fTEVAR)后内漏的有效性.方法 2018年8月至2020年12月,16例fTEVAR术后内漏患者均接受可控结合弹簧圈栓塞技术治疗.其中男12例,女4例;年龄为(61.6±14.0)岁.观察手术成功率和并发症发生率,并通过CT随访观察临床疗效.结果 16例患者可控弹簧圈结合普通弹簧圈栓塞手术均获成功.其中Ⅰa型内漏14例,Ⅱ型内漏2例.术后随访(5.01±2.81)(2~10)个月,无脑梗死、截瘫等神经系统并发症发生,无死亡;3例随访时仍见假腔内有对比剂充盈,予二次栓塞手术,术后随访假腔内出现完全血栓形成.结论 可控弹簧圈结合普通弹簧圈栓塞技术手术创伤小,技术简单易行,是治疗fTEVAR术后内漏安全有效的方法之一.Objective To evaluate the effectiveness of controllable coil combined with common coil embolization in treating endoleak occurring after fenestration/stenting thoracic endovascular aortic repair(fTEVAR)of thoracic aortic dissection.Methods A total of 16 patients with endoleak occurring after fTEVAR treatment,who received controllable coil combined with common coil embolization between August 2018 and November 2020,were enrolled in this study.The patients included 12 males and 4 females,with a mean age of(61.6±14.0)years.The success rate of operation and the incidence of complications were calculated,and follow-up CT examination was performed to evaluated the clinical effect.Results Successful controllable coil combined with common coil embolization was accomplished in all 16 patients.Among the 16 patients,Ia type endoleak was seen in 14 and II type endoleak in 2.The patients were followed up for 2-10 months,with a mean of(5.01±2.81)months.No neurological complications,such as cerebral infarction and paraplegia,nor death occurred.During follow-up period,angiography showed that contrast agent filling in the false lumen was still observed in 3 patients,a second time of embolization procedure had to be carried out,and postoperative follow-up examination revealed that the false lumen achieved complete thrombosis.Conclusion Being minimally-invasive and technically-simple,controllable coil combined with common coil embolization is a safe and effective treatment for endoleak after fTEVAR.

关 键 词：内漏 弹簧圈栓塞 开窗技术 胸主动脉夹层 

分 类 号：R654[医药卫生—外科学]