单分支主动脉支架在锚定区不足的胸主动脉腔内修复术中的应用  

Experiences of single-branched stent graft in thoracic aortic endovascular repair with insufficient anchoring area

作　　者：郭伟 郭俊晓[1] 刘志平[1] GUO Wei;GUO Junxiao;LIU Zhiping(Department of Cardiac and Vascular Surgery,The Affiliated Hospital of Inner Mongolia Medical University,Hohhot 010050,China)

机构地区：[1]内蒙古医科大学附属医院心脏大血管外科,010050

出　　处：《心肺血管病杂志》2023年第5期449-452,471,共5页Journal of Cardiovascular and Pulmonary Diseases

摘　　要：目的:研究单分支主动脉支架在锚定区不足的胸主动脉腔内修复术的应用。方法:回顾性分析2019年10月至2021年10月,于内蒙古医科大学附属医院心脏大血管外科收治的18例锚定区不足的主动脉疾病患者临床资料。结果:男性14例,女性4例,年龄(57.1±13.5)岁,体质量(78.6±5.1)kg,包括急性Standford B型主动脉夹层10例,主动脉穿透性溃疡6例,胸主动脉假性动脉瘤2例。手术时间(2.6±0.4)h,成功率100%,无内漏,无围术期死亡,无神经系统及上肢缺血并发症。随访时间12个月,所有患者主动脉及分支支架通畅率为100%,支架近端无明显内漏,假腔均出现血栓化,无神经系统及左上肢缺血表现。结论:对近端锚定区不足的主动脉疾病患者应用单分支主动脉支架行胸主动脉腔内修复安全有效,左锁骨下动脉重建效果良好,中长期效果需要继续评估。Objective:To discuss the clinical value of single-branched aortic stent graft in treating aortic disease with insufficient sealing area.Methods:This was a retrospective analysis of 18 patients who had treatment from October 2019 to October 2021 at the Affiliated Hospital of Inner Mongolia Medical University’s Department of Cardiac and Vascular Surgery.Single-branched stent graft was adopted to treat 18 patients with aortic disease.Results:There were 14 males and 4 females,aged(57.1±13.5)years and weight(78.6±5.1)Kg,including 10 cases of acute Standford type B aortic dissection,6 cases of penetrating aortic ulcer and 2 cases of thoracic aortic pseudoaneurysm.The operation time was(2.6±0.4)h,the success rate was 100%,there was no endoleak,no perioperative death,no complications of nervous system and upper limb ischemia.During the follow-up period of 12 months,the patency of the main and branch stents was 100%in all patients,and there was no obvious endoleak in the proximal end of the stents.Thrombosis occurred in the false lumen,and there was no neurological or left upper limb ischemia.Conclusions:Thoracic endovascular aortic repair with single-branched stent graft is safe and effective in patients with aortic disease with insufficient proximal sealing area.The reconstruction of left subclavian artery has good results.The medium and long-term effects need to be evaluated.

关 键 词：单分支主动脉支架 胸主动脉腔内修复术 左锁骨下动脉 主动脉疾病 

分 类 号：R54[医药卫生—心血管疾病]