CAJ | 학술논문

目的探讨覆膜支架主动脉腔内修复术(endovascular aortic repair,EVAR)治疗创伤性胸主动脉损伤(traumatic thoracic aortic injuries,TTAI)的可行性和有效性. 方法回顾性分析13例TTAI患者的临床资料,术前螺旋CT血管造影(CTA)对病变进行评估,术中数字减影血管造影(DSA)进一步评估及行EVAR.术后3,6,12个月以及其后每年随访CTA明确治疗效果. 结果 13例行EVAR均获成功.完全或部分遮蔽左锁骨下动脉4例,支架释放后即刻造影发现内漏3例,加短支架2次覆盖后内漏消失1例,行球囊扩张贴附后内漏明显减少1例,另1例微小内漏予观察随访.共12例获随访,无内漏、左上肢缺血、截瘫以及支架移位等并发症. 结论 EVR治疗TTAI安全性高,效果满意.
목적 탐토복막지가주동맥강내수복술(endovascular aortic repair,EVAR)치료창상성흉주동맥손상(traumatic thoracic aortic injuries,TTAI)적가행성화유효성. 방법 회고성분석13례TTAI환자적림상자료,술전라선CT혈관조영(CTA)대병변진행평고,술중수자감영혈관조영(DSA)진일보평고급행EVAR.술후3,6,12개월이급기후매년수방CTA명학치료효과. 결과 13례행EVAR균획성공.완전혹부분차폐좌쇄골하동맥4례,지가석방후즉각조영발현내루3례,가단지가2차복개후내루소실1례,행구낭확장첩부후내루명현감소1례,령1례미소내루여관찰수방.공12례획수방,무내루、좌상지결혈、절탄이급지가이위등병발증. 결론 EVR치료TTAI안전성고,효과만의.
Objective To investigate feasibility and validity of endovascular aortic repair (EVAR) of traumatic thoracic aortic injuries (TTAI).Methods A retrospective analysis was conducted on data of 13 patients with TTAI.Pathological changes were evaluated by spinal CT angiography (CTA) preoperatively and re-evaluated by digital subtraction angiography (DSA) in EVAR.CTA was performed again to confirm therapeutic effects at postoperative 3,6,12 months and annually thereafter.Results All patients had successful EVAR.Complete or partial cover of left subclavian artery was observed in four patients.Endoleak in angiography shortly after stent delivery was noticed in three patients.However,endoleak disappeared in one patient after short stent placement for twice; endoleak was evidently decreased in one patient after balloon dilation.Follow-up was performed for another patient with slight endoleak.A total of 12 patients were followed up,which showed no complications,such as endoleak,ischemia of left upper extremity,paralysis or stent-graft migration.Conclusion EVR is safe and effective in treatment of TTAI.