CAJ | 학술논문

目的：探讨裸支架“烟囱”技术在主动脉夹层伴左颈总动脉破口腔内隔绝术中的应用及治疗效果。方法回顾性分析2012年2月至2014年3月青海省人民医院采用裸支架“烟囱”技术行腔内隔绝术治疗的7例主动脉夹层伴左颈总动脉破口患者的临床资料。在腔内覆膜支架封堵主动脉夹层破口的同时，以“烟囱”裸支架隔绝左颈总动脉破口，重建左颈总动脉血流。术后2周行CTA检查，观察疗效及有无内漏、支架移位等并发症。结果腔内隔绝手术成功率为100％，无Ⅰ型内漏发生。术后随访1~13个月，主动脉内覆膜支架位置良好，左颈总动脉内“烟囱”支架通畅，无内漏、支架移位等并发症发生。结论裸支架“烟囱”技术可以为主动脉夹层伴左颈总动脉破口患者提供腔内隔绝术治疗机会，完全封堵漏口，重建血流。短期随访疗效满意，远期疗效有待进一步随访观察。
목적：탐토라지가“연창”기술재주동맥협층반좌경총동맥파구강내격절술중적응용급치료효과。방법회고성분석2012년2월지2014년3월청해성인민의원채용라지가“연창”기술행강내격절술치료적7례주동맥협층반좌경총동맥파구환자적림상자료。재강내복막지가봉도주동맥협층파구적동시，이“연창”라지가격절좌경총동맥파구，중건좌경총동맥혈류。술후2주행CTA검사，관찰료효급유무내루、지가이위등병발증。결과강내격절수술성공솔위100％，무Ⅰ형내루발생。술후수방1~13개월，주동맥내복막지가위치량호，좌경총동맥내“연창”지가통창，무내루、지가이위등병발증발생。결론라지가“연창”기술가이위주동맥협층반좌경총동맥파구환자제공강내격절술치료궤회，완전봉도루구，중건혈류。단기수방료효만의，원기료효유대진일보수방관찰。
Objective To discuss the application of bare-stent“chimney”technique in treating aortic dissection associated with left common carotid rupture, and to evaluate its therapeutic effect. Methods The clinical data of 7 patients with aortic dissection accompanied with left common carotid rupture, who were admitted to Qinghai Provincial People’s Hospital during the period from February 2012 to March 2014 to receive endovascular isolation operation treatment with bare-stent “chimney” technique, were retrospectively analyzed. When the rupture of aortic dissection was occluded with covered-stent, the left common carotid rupture was isolated with “chimney”bare-stent to reconstruct the blood flow of left common carotid artery. CT angiography was performed 2 weeks after the operation to check if there was any complication such as endoleak, stent migration, etc. Results The technical success rate of endovascular isolation operation was 100%. No type I endoleak occurred. The patients were followed up for 1-13 months, the covered stent in the aorta was in good position, and the “chimney” bare-stent in the left common carotid artery was patent. No complications such as endoleak, stent migration, etc. occurred. Conclusion Bare-stent“chimney”technology can provide treatment opportunity for the patients suffering from left common carotid artery rupture accompanied by aortic dissection; the rupture can be completely obstructed and the blood flow can be reconstructed. The short-term effect is satisfactory, although the long-term effect needs to be further studied.