中华医学杂志
中華醫學雜誌
중화의학잡지
National Medical Journal of China
2012年
47期
3333-3335
,共3页
夹层,主动脉%腹腔干%支架%弹簧圈
夾層,主動脈%腹腔榦%支架%彈簧圈
협층,주동맥%복강간%지가%탄황권
Dissection,aortic%Celiac trunk%Stent%Coils
目的 探讨裸支架联合弹簧圈治疗远端破口位于腹腔干的主动脉夹层的新方法.方法 上海交通大学附属第六人民医院血管外科2007年4月至2010年8月,2例Stanford B型主动脉夹层近端破口以覆膜支架封闭后,确认远端破口位于腹腔干且难以自愈,采用裸支架植入腹腔干,跨过破口,并以导管经支架网孔穿过破口进入假腔,将适当数量的弹簧圈植入假腔,在阻断进入假腔的血流的同时保持腹腔干动脉通畅.结果 手术均成功,术后造影假腔不显影,腹腔干通畅.无并发症发生.分别随访5年和2年,假腔消失,腹腔干通畅.结论 裸支架联合弹簧圈,技术简单,仅需穿刺即可完成,避免了开放手术、杂交手术的巨大创伤,理论上可以用于破口位于腹腔各个大分支动脉的情形,作为腔内修复术的补充技术,使部分复杂Stanford B型夹层达到“根治”效果.
目的 探討裸支架聯閤彈簧圈治療遠耑破口位于腹腔榦的主動脈夾層的新方法.方法 上海交通大學附屬第六人民醫院血管外科2007年4月至2010年8月,2例Stanford B型主動脈夾層近耑破口以覆膜支架封閉後,確認遠耑破口位于腹腔榦且難以自愈,採用裸支架植入腹腔榦,跨過破口,併以導管經支架網孔穿過破口進入假腔,將適噹數量的彈簧圈植入假腔,在阻斷進入假腔的血流的同時保持腹腔榦動脈通暢.結果 手術均成功,術後造影假腔不顯影,腹腔榦通暢.無併髮癥髮生.分彆隨訪5年和2年,假腔消失,腹腔榦通暢.結論 裸支架聯閤彈簧圈,技術簡單,僅需穿刺即可完成,避免瞭開放手術、雜交手術的巨大創傷,理論上可以用于破口位于腹腔各箇大分支動脈的情形,作為腔內脩複術的補充技術,使部分複雜Stanford B型夾層達到“根治”效果.
목적 탐토라지가연합탄황권치료원단파구위우복강간적주동맥협층적신방법.방법 상해교통대학부속제륙인민의원혈관외과2007년4월지2010년8월,2례Stanford B형주동맥협층근단파구이복막지가봉폐후,학인원단파구위우복강간차난이자유,채용라지가식입복강간,과과파구,병이도관경지가망공천과파구진입가강,장괄당수량적탄황권식입가강,재조단진입가강적혈류적동시보지복강간동맥통창.결과 수술균성공,술후조영가강불현영,복강간통창.무병발증발생.분별수방5년화2년,가강소실,복강간통창.결론 라지가연합탄황권,기술간단,부수천자즉가완성,피면료개방수술、잡교수술적거대창상,이론상가이용우파구위우복강각개대분지동맥적정형,작위강내수복술적보충기술,사부분복잡Stanford B형협층체도“근치”효과.
Objective To evaluate a novel method of combining use of bare stent and coils in the treatment of aortic dissection with distal tear at celiac trunk.Methods From April 2007 to August 2010,two cases of Stanford type B dissections underwent initially endovascular stent-grafting to seal proximal tears while distal tears at celiac trunks failed to seal spontaneously.Bare stents were then implanted into celiac trunks crossing tears.And an appropriate amount of coils were pushed into false lumen via a catheter passing through the holes of stents for maintaining the patency of celiac trunk and sealing tears.Results Both procedures succeeded.False lumen was indistinct on angiography while celiac trunks were patent.No complication occurred.After the follow-up periods of 5 and 2 years respectively,false lumen disappeared and celiac arteries became patent.Conclusion The novel method of combining use of bare stent and coils is technically simple.It required a simple puncture.Major traumas of open and hybrid operations are avoided.It is also indicated for cases of tears at renal or superior mesenteric arteries.As a supplemental method for conventional TEVAR,radical cure may be achieved for some complicated Stanford B dissections.
