中国血管外科杂志（电子版）
中國血管外科雜誌（電子版）
중국혈관외과잡지（전자판）
CHINESE JOURNAL OF VASCULAR SURGERY(ELECTRONIC VERSION)
2013年
4期
214-216,221
,共4页
焦元勇%章希炜%邹君杰%杨宏宇%马昊%蒋军
焦元勇%章希煒%鄒君傑%楊宏宇%馬昊%蔣軍
초원용%장희위%추군걸%양굉우%마호%장군
主动脉弓%杂交技术%烟囱技术%分支支架
主動脈弓%雜交技術%煙囪技術%分支支架
주동맥궁%잡교기술%연창기술%분지지가
Aortic arch%Hybrid techniques%Chimney-graft techniques%Branched stent-grafts
目的探讨主动脉弓部病变延长锚定区的方法及其疗效。方法2005年8月~2013年8月，共56例主动脉弓部病变涉及延长锚定区的处理。延长锚定区的方法包括杂交技术，“烟囱”支架和分支支架。结果行杂交手术13例，烟囱技术36例，分支支架7例，患者均成功进行一期腔内修复术，支架植入后数字减影血管造影显示病变完全隔绝。围手术期无死亡、脑梗死和肾功能不全等并发症发生。随访时间1~66个月，旁路手术桥血管通畅，支架人造血管无移位，瘤腔血栓形成，瘤腔体积无增长。“烟囱”植入分支通畅，1例双烟囱技术治疗患者轻度I型内漏。分支支架均无明显内漏，分支血管通畅。结论通过仔细对病变的评估，个性化使用目前的延长锚定区方法，与常规腔内治疗结合可以拓宽胸主动脉腔内修复术的手术适应证，改善主动脉弓部疾病的临床治疗预后。
目的探討主動脈弓部病變延長錨定區的方法及其療效。方法2005年8月~2013年8月，共56例主動脈弓部病變涉及延長錨定區的處理。延長錨定區的方法包括雜交技術，“煙囪”支架和分支支架。結果行雜交手術13例，煙囪技術36例，分支支架7例，患者均成功進行一期腔內脩複術，支架植入後數字減影血管造影顯示病變完全隔絕。圍手術期無死亡、腦梗死和腎功能不全等併髮癥髮生。隨訪時間1~66箇月，徬路手術橋血管通暢，支架人造血管無移位，瘤腔血栓形成，瘤腔體積無增長。“煙囪”植入分支通暢，1例雙煙囪技術治療患者輕度I型內漏。分支支架均無明顯內漏，分支血管通暢。結論通過仔細對病變的評估，箇性化使用目前的延長錨定區方法，與常規腔內治療結閤可以拓寬胸主動脈腔內脩複術的手術適應證，改善主動脈弓部疾病的臨床治療預後。
목적탐토주동맥궁부병변연장묘정구적방법급기료효。방법2005년8월~2013년8월，공56례주동맥궁부병변섭급연장묘정구적처리。연장묘정구적방법포괄잡교기술，“연창”지가화분지지가。결과행잡교수술13례，연창기술36례，분지지가7례，환자균성공진행일기강내수복술，지가식입후수자감영혈관조영현시병변완전격절。위수술기무사망、뇌경사화신공능불전등병발증발생。수방시간1~66개월，방로수술교혈관통창，지가인조혈관무이위，류강혈전형성，류강체적무증장。“연창”식입분지통창，1례쌍연창기술치료환자경도I형내루。분지지가균무명현내루，분지혈관통창。결론통과자세대병변적평고，개성화사용목전적연장묘정구방법，여상규강내치료결합가이탁관흉주동맥강내수복술적수술괄응증，개선주동맥궁부질병적림상치료예후。
Objective To discuss the methods and their efficacy of extending landing zone in treatment of aortic arch lesions. Methods From August 2005 to August 2013, 56 cases with aortic arch lesions needed to prolong the landing zone. Three strategies were employed to lengthen the proximal landing zone, including hybrid techniques, chimney-graft techniques and branched stent-grafts. Results For 56 cases, hybrid technique, chimney-graft technique and branched stent-graft technique were successfully performed in 13, 36 and 7 cases during endovascular repair, respectively.The digital subtraction angiography(DSA)showed that the lesions were isolated well. During the perioperative period, no complications such as death, stroke and kidney dysfunction occurred. During the follow-up (from 1~66 months), the bridge vessels were patent and artificial blood vessels did not migrate. The thrombosis formed in false lumen and there was no enlargement of the volume. The branch arteries with chimney stents were patent. Mild typeⅠendoleak occurred in 1 case with 2 chimney grafts and no endoleak was observed in branched stent-grafts. Conclusion By careful evaluation for lesions, the methods of extending the landing zone combined with conventional endovascular repair can expand the indications of thoracic endovascular aortic repair (TEVAR), and make improvements for the prognosis of aortic arch diseases.
