可扩张鞘管在复杂髂股动脉入路经皮胸主动脉腔内修复术的安全性与有效性研究  

Safety and efficacy of expandable sheaths in complex iliofemoral access for percutaneous thoracic endovascular aneurysm repair

作　　者：俞靖凡 徐国雄[1] 张志轩[1] 方昌文 许晨 顾一名 金一琦[1] YU Jingfan;XU Guoxiong;ZHANG Zhixuan;FANG Changwen;XU Chen;GU Yiming;JIN Yiqi(Department of Vascular Surgery and Intervention,The Affiliated Suzhou Hospital of Nanjing Medical University,Suzhou 215000,China)

机构地区：[1]南京医科大学附属苏州医院介入与血管外科,215000

出　　处：《心肺血管病杂志》2024年第10期1079-1084,共6页Journal of Cardiovascular and Pulmonary Diseases

基　　金：苏州卫建委2023年临床重点病种诊疗技术专项项目(LCZX202314)。

摘　　要：目的:本研究评估在经皮胸主动脉腔内修复术(thoracic endovascular aneurysm repair TEVAR)中,可扩张鞘管用于复杂髂股动脉入路的安全性和有效性。方法:回顾性分析2023年1月至2023年12月,在本中心接受TEVAR治疗的18例患者,其中男性12例,女性6例。共纳入25个髂股动脉入路。随访并记录术前、术后30d和90d随访患者髂股动脉入路血管直径及相关并发症情况。结果:技术成功率为100%。术后30d随访入路血管最小直径及平均直径较术前增大值中位数分别为0.5(0.1,1.2)mm(Z=-4.207,P<0.001)、0.2(0.1,0.3)mm(Z=-3.096,P=0.002),术后90d随访入路最小直径及平均直径较术后30d变化,差异无统计学意义(P>0.05)。1例患者发生假性动脉瘤(SIR2级),经皮注射凝血酶治疗。随访期间无其他入路相关并发症发生,总并发症发生率为4%。结论:在TEVAR术中将可扩张鞘管应用于复杂髂股动脉入路是安全有效的。Objective:This study evaluates the safety and efficacy of using expandable sheaths for complex iliofemoral access in thoracic endovascular aneurysm repair(TEVAR).Methods:A retrospective analysis was conducted on 18 patients(12 males,6 females)treated with TEVAR at our center from January 2023 to December 2023,involving 25 iliofemoral accesses.The diameter of the access vessels and related complications were recorded and followed up preoperatively,30 days,and 90 days postoperatively.Results:The technical success rate was 100%.At the 30-day postoperative follow-up,the median increase values of the minimum and mean diameter of the approach vessel were 0.5(0.1,1.2)mm(Z=-4.207,P<0.001)and 0.2(0.1,0.3)mm(Z=-3.096,P=0.002)respectively,compared to preoperative measurements.There was no statistically significant change in the minimum and average diameters at the 90-day postoperative follow-up compared to the 30-day follow-up(P>0.005).One patient developed a pseudoaneurysm(SIR 2),which was treated with percutaneous thrombin injection.No other access-related complications occurred during the follow-up period,with a total complication rate of 4%.Conclusion:The use of expandable sheaths for complex iliofemoral access in TEVAR is safe and effective.

关 键 词：可扩张鞘管 胸主动脉腔内修复术 复杂髂股动脉入路 

分 类 号：R54[医药卫生—心血管疾病]