胸主动脉腔内修复术后内漏发生机制与处理  

Mechanism and treatment of endoleak after thoracic endovascular aortic repair

作　　者：黎明[1] 舒畅[1,2] Li Ming;Shu Chang(Institute of Vascular Disease,Central South University,Changsha 410011,China;National Key Laboratory of Cardiovascular Disease,Center of Vascular Surgery,Fuwai Hospital,National Center for Cardiovascular Disease,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100037,China)

机构地区：[1]中南大学血管病研究所,长沙410011 [2]中国医学科学院北京协和医学院,国家心血管病中心,阜外医院血管外科中心心血管疾病国家重点实验室,北京100037

出　　处：《中华血管外科杂志》2025年第1期1-5,共5页Chinese Journal of Vascular Surgery

摘　　要：胸主动脉腔内修复术(TEVAR)是治疗胸主动脉疾病的一种重要微创技术,内漏为其术后的常见并发症,显著影响患者的长期预后。内漏发生的危险因素包括近端锚定区不足、血管成角过大、支架尺寸不匹配及术后血压控制不佳等。临床处理需依据内漏来源和解剖学及血流动力学特点制定个体化治疗方案,术后规律随访及优化血压管理对减少迟发性内漏的发生风险至关重要。本文旨在系统探讨TEVAR术后内漏的分型、发生机制及处理策略,为临床决策提供参考。Thoracic endovascular aortic repair(TEVAR)is an important minimally invasive technique for the treatment of thoracic aortic diseases.Endoleak is a common postoperative complication that significantly affects patients'long-term prognosis.Risk factors for endoleak include insufficient proximal anchoring zones,excessive vascular angulation,stent size mismatch,and poor postoperative blood pressure control.Clinical management strategies should be individualized based on the source of the endoleak,as well as anatomical and hemodynamic characteristics.Regular postoperative follow-up and optimized blood pressure management are crucial in reducing the risk of delayed endoleak.This article aims to systematically discuss the classifications,mechanisms and management strategies of endoleaks following TEVAR,providing a reference for clinical decision-making.

关 键 词：胸主动脉腔内修复术 内漏 发生机制 

分 类 号：R65[医药卫生—外科学]