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
2014年
11期
660-664
,共5页
郭曦%李彭%黄小勇%刘光锐%李铁铮%薛玉国%周西%黄连军
郭晞%李彭%黃小勇%劉光銳%李鐵錚%薛玉國%週西%黃連軍
곽희%리팽%황소용%류광예%리철쟁%설옥국%주서%황련군
主动脉瘤,腹%腔内修复术%反向腔内覆膜支架转流术%髂动脉
主動脈瘤,腹%腔內脩複術%反嚮腔內覆膜支架轉流術%髂動脈
주동맥류,복%강내수복술%반향강내복막지가전류술%가동맥
Aortic aneurysm,abdominal%Endovascular aortic repair%Crossover chimney%Ⅰ artery
目的 分析腹主动脉瘤腔内修复术并反向“烟囱”技术应用支架组合治疗腹主动脉瘤累及双侧髂动脉需同时覆盖双侧髂内动脉开口的效果,以指导手术,并评估预后.方法 截至2013年7月,5例腹主动脉瘤累及双侧髂动脉患者行腹主动脉瘤腔内修复术并反向“烟囱”转流术,均为男性,年龄(65.0±3.6)岁.观察术中置入支架即刻造影及术后1个月、3个月CTA图像,分析动脉瘤支架及反向“烟囱”支架的效果.结果 术中置入支架即刻造影显示腹主动脉瘤完全隔绝,转流支架通畅,转流侧髂内动脉显影良好.术后1个月、3个月CTA显示所有患者未出现支架内漏和支架移位等并发症.腹主动脉支架选择Endurant(Medtronic美国,1例)和EXCLUDER PXT(GORE美国,3例)的患者转流支架内可见造影剂充盈,转流侧髂内动脉及其分支显影良好,1例选择Zenith(COOK美国)者自转流支架开口处闭塞.结论 对于腹主动脉瘤累及双侧髂动脉需行腔内修复术并覆盖双侧髂内动脉患者,同时并行反向“烟囱”技术可以保护单侧髂内动脉及盆腔血供,但需慎重选择支架组合,建议同品牌材质进行组合应用;远期疗效还需进一步扩大病例随访观察.
目的 分析腹主動脈瘤腔內脩複術併反嚮“煙囪”技術應用支架組閤治療腹主動脈瘤纍及雙側髂動脈需同時覆蓋雙側髂內動脈開口的效果,以指導手術,併評估預後.方法 截至2013年7月,5例腹主動脈瘤纍及雙側髂動脈患者行腹主動脈瘤腔內脩複術併反嚮“煙囪”轉流術,均為男性,年齡(65.0±3.6)歲.觀察術中置入支架即刻造影及術後1箇月、3箇月CTA圖像,分析動脈瘤支架及反嚮“煙囪”支架的效果.結果 術中置入支架即刻造影顯示腹主動脈瘤完全隔絕,轉流支架通暢,轉流側髂內動脈顯影良好.術後1箇月、3箇月CTA顯示所有患者未齣現支架內漏和支架移位等併髮癥.腹主動脈支架選擇Endurant(Medtronic美國,1例)和EXCLUDER PXT(GORE美國,3例)的患者轉流支架內可見造影劑充盈,轉流側髂內動脈及其分支顯影良好,1例選擇Zenith(COOK美國)者自轉流支架開口處閉塞.結論 對于腹主動脈瘤纍及雙側髂動脈需行腔內脩複術併覆蓋雙側髂內動脈患者,同時併行反嚮“煙囪”技術可以保護單側髂內動脈及盆腔血供,但需慎重選擇支架組閤,建議同品牌材質進行組閤應用;遠期療效還需進一步擴大病例隨訪觀察.
목적 분석복주동맥류강내수복술병반향“연창”기술응용지가조합치료복주동맥류루급쌍측가동맥수동시복개쌍측가내동맥개구적효과,이지도수술,병평고예후.방법 절지2013년7월,5례복주동맥류루급쌍측가동맥환자행복주동맥류강내수복술병반향“연창”전류술,균위남성,년령(65.0±3.6)세.관찰술중치입지가즉각조영급술후1개월、3개월CTA도상,분석동맥류지가급반향“연창”지가적효과.결과 술중치입지가즉각조영현시복주동맥류완전격절,전류지가통창,전류측가내동맥현영량호.술후1개월、3개월CTA현시소유환자미출현지가내루화지가이위등병발증.복주동맥지가선택Endurant(Medtronic미국,1례)화EXCLUDER PXT(GORE미국,3례)적환자전류지가내가견조영제충영,전류측가내동맥급기분지현영량호,1례선택Zenith(COOK미국)자자전류지가개구처폐새.결론 대우복주동맥류루급쌍측가동맥수행강내수복술병복개쌍측가내동맥환자,동시병행반향“연창”기술가이보호단측가내동맥급분강혈공,단수신중선택지가조합,건의동품패재질진행조합응용;원기료효환수진일보확대병례수방관찰.
Objective To discuss the effect and evaluate prognosis for different stent combination in the patient with AAA and bilateral inner iliac arteries are involved and applying EVAR and crossover chimney simultaneously.Methods Until July 2013,the center applied EVAR and crossover chimney in AAA for 5 male patients,aged(65.0 ±3.6) years,were observed intraoperative radiography and CTA imaging after operation at 1 st and 3rd month,analysize the curative effect.Results After intervention,DSA show that AAA be repaired,bypass-stent and ipsilateral inner iliac artery unobstructed.CTA review in 1 and 3 month later show there is no leakage or displacement and other complications.Endurant (Medtronic,USA) be used in 1 case and ExcluderPXT (GORE,USA) be selected in 3 cases,inner iliac artery are unobstructed in this 4 cases; Zenith (Cook,USA) be used in 1 case,but the chimney stent is obstructed.Conclusion For the patient has AAA and bilateral inner iliac arteries are involved,applying EVAR and crossover chimney simultaneously possible preserve unilateral inner iliac artery,however combination during different stents need paying more attention,using the stent with identical material is suggested,still need more cases to analysis forward curative effect.
