中华胸心血管外科杂志
中華胸心血管外科雜誌
중화흉심혈관외과잡지
Chinese Journal of Thoracic and Cardiovascular Surgery
2008年
5期
297-300
,共4页
刘愚勇%张宏家%李海洋%贡鸣%王晓龙%孙衍庆
劉愚勇%張宏傢%李海洋%貢鳴%王曉龍%孫衍慶
류우용%장굉가%리해양%공명%왕효룡%손연경
主动脉瘤,胸%支架%锁骨下动脉
主動脈瘤,胸%支架%鎖骨下動脈
주동맥류,흉%지가%쇄골하동맥
Aortic aneurysm,thoracic%Stents%Subelavian artery
目的 总结利用左锁骨下动脉(LSA)开口为锚定区行腔内治疗胸主动脉瘤的经验和体会.方法 2003年10月至2007年7月共完成覆膜支架腔内隔绝术治疗胸主动脉瘤146例,其中男106例,女40例;年龄29~72岁,平均(53.7±13.8)岁.其中Stanford B型夹层动脉瘤133例,破口位于降主动脉的Stanford A型4例,假性动脉瘤6例,外伤致胸降主动脉破裂3例.锚定区为LSA开口(Z2区)者30例(21%).结果 全组无围术期死亡.无脊髓损伤、支架移位、急性脑缺血、左上肢功能受损等严重并发症.术后平均住院(4.0±1.3)d.术后并发症包括发热35例,Ⅳ型内漏14例,Ⅰ型内漏2例,肾功能衰竭和一过性晕厥各1例.随访1~48个月,期间无严重并发症.结论 覆膜支架腔内隔绝术是一种治疗胸主动脉瘤的有效方法,手术创伤小、术后恢复快,疗效肯定、安全性高.部分病例可以利用LSA开口为锚定区,以扩大腔内治疗的范围,增加手术的安全性.
目的 總結利用左鎖骨下動脈(LSA)開口為錨定區行腔內治療胸主動脈瘤的經驗和體會.方法 2003年10月至2007年7月共完成覆膜支架腔內隔絕術治療胸主動脈瘤146例,其中男106例,女40例;年齡29~72歲,平均(53.7±13.8)歲.其中Stanford B型夾層動脈瘤133例,破口位于降主動脈的Stanford A型4例,假性動脈瘤6例,外傷緻胸降主動脈破裂3例.錨定區為LSA開口(Z2區)者30例(21%).結果 全組無圍術期死亡.無脊髓損傷、支架移位、急性腦缺血、左上肢功能受損等嚴重併髮癥.術後平均住院(4.0±1.3)d.術後併髮癥包括髮熱35例,Ⅳ型內漏14例,Ⅰ型內漏2例,腎功能衰竭和一過性暈厥各1例.隨訪1~48箇月,期間無嚴重併髮癥.結論 覆膜支架腔內隔絕術是一種治療胸主動脈瘤的有效方法,手術創傷小、術後恢複快,療效肯定、安全性高.部分病例可以利用LSA開口為錨定區,以擴大腔內治療的範圍,增加手術的安全性.
목적 총결이용좌쇄골하동맥(LSA)개구위묘정구행강내치료흉주동맥류적경험화체회.방법 2003년10월지2007년7월공완성복막지가강내격절술치료흉주동맥류146례,기중남106례,녀40례;년령29~72세,평균(53.7±13.8)세.기중Stanford B형협층동맥류133례,파구위우강주동맥적Stanford A형4례,가성동맥류6례,외상치흉강주동맥파렬3례.묘정구위LSA개구(Z2구)자30례(21%).결과 전조무위술기사망.무척수손상、지가이위、급성뇌결혈、좌상지공능수손등엄중병발증.술후평균주원(4.0±1.3)d.술후병발증포괄발열35례,Ⅳ형내루14례,Ⅰ형내루2례,신공능쇠갈화일과성훈궐각1례.수방1~48개월,기간무엄중병발증.결론 복막지가강내격절술시일충치료흉주동맥류적유효방법,수술창상소、술후회복쾌,료효긍정、안전성고.부분병례가이이용LSA개구위묘정구,이확대강내치료적범위,증가수술적안전성.
Objective To evaluated the relationship between the site of the proximal landing zone during endovascular repair of thoracic aortic aneurysm and treatment outcomes. Methods From October 2003 to July 2007, 146 patients[106 males, 40 females, mean age (53.7±13.8) years, range 29-72 years] were underwent endovascular stent-graft exchusion for thoracic aortic aneurysm, including Stanford B in 133 patieents and Stanford A in4, pseudoaneurysm in 6, and traumatic aortic rupture in 3. Proximal landing zone at origin of LSA(Z2 zone)were 30 patients(21%). Results There were no death and no instances of spinal cord ischemic injury, stent displacement or acute cerebral ischemic injury. Postoperative hospital stay time was (4.0±1.3) days. Camplications included fever in 35 patients, type Ⅳ endoleak in 14 patients,type Ⅰ endoleak in 2 patient and acute renal dysfunction in 1 patient and dizziness in 1 patient. Conclusion Endovascular thoracic aorta repair is an effective, less invasive and sdfe surgery for patients with thoracic aortic aneurysm. Coverage of the origin of the left subclavian artery to obtain adequate proximal landing zone during endograft treatment is well tolerated.