顺行原位开窗技术重建腹主动脉内脏分支的发展现状和焦点问题  

Development Status and key issues of the antegrade in-situ fenestration technique for reconstructing the visceral branch of the abdominal aorta

作　　者：王一淑 李栋林[1] 张鸿坤[1] Wang Yishu;Li Donglin;Zhang Hongkun(Department of Vascular Surgery,The First Affiliated Hospital,Zhejiang University School of Medicine,Hangzhou 310003,China)

机构地区：[1]浙江大学医学院附属第一医院血管外科,杭州310013

出　　处：《中华血管外科杂志》2024年第5期346-350,共5页Chinese Journal of Vascular Surgery

摘　　要：胸腹主动脉夹层/动脉瘤或累及内脏区的复杂腹主动脉瘤, 其病情凶险危及生命, 临床治疗极具挑战。腔内治疗中的原位开窗技术, 因其术前所需准备时间较短, 设备要求相对不高, 较适用于腹主动脉瘤破裂、主动脉外伤等急诊手术, 可快速实现主动脉破口的覆盖。然而, 腹主动脉内脏分支重建因其特殊的解剖特点, 不能常规对内脏区进行切开解剖穿刺, 只能顺行开窗。本文从分支动脉定位、精准穿刺开窗、支架桥接三个部分, 分别阐述该技术的发展现状和焦点问题。The thoracoabdominal aortic dissection/aneurysm,and complex abdominal aortic aneurysm(AAA)involving the visceral area are life-threatening conditions imposing significant challenges in clinical treatment.In-situ fenestration technique for endovascular treatment is suitable for emergency surgeries such as ruptured AAA or traumatic aortic injuries because of its shorter preoperative preparation time and relatively lower equipment requirements,enabling rapid coverage of the aortic crevasse.However,the routine open dissection or puncture in the visceral area is not feasible in abdominal aortic visceral branch reconstruction because of its special anatomical characteristics,thus requiring antegrade fenestration.This paper aims to illustrate the development status and key issues concerning the antegrade in-situ fenestration technique from three aspects:branch artery positioning,precise puncture in fenestration,and stent bridging.

关 键 词：主动脉疾病 主动脉瘤 腹 腔内治疗 顺行原位开窗技术 分支血管 

分 类 号：R65[医药卫生—外科学]