摘要
目的总结腹主动脉瘤腔内修复术使用Endurant支架的经验及体会。方法回顾分析2010年5月至2011年5月北京协和医院血管外科收治的19例肾下腹主动脉瘤使用Endurant支架行腔内修复术的病例特点、术后并发症和近期随访结果。结果19例患者均获得手术成功，其中9例为复杂解剖形态的病例。术中同时进行的肾动脉支架、髂内动脉栓塞和髂动脉扩张也均获得成功。术后无I、Ⅲ和Ⅳ型内漏发生，4例残余Ⅱ型内漏留待观察。围手术期无死亡病例，30d并发症主要包括血栓消耗性凝血功能障碍，心肌梗死合并心衰，伤口感染和血肿。全组随访1～12个月，无死亡病例。8例患者完成至少1次CT动脉重建（computer tomography angiography，CTA）检查，5例动脉瘤体直径缩小，3例无改变。1例患者出现单侧髂腿延长支闭塞，行股股动脉转流。1例患者出现继发性IB型内漏，继续观察。结论腹主动脉瘤腔内修复术使用Endurant支架安全，有效。Endurant支架增加了对于复杂解剖形态的病例的手术成功率，近期疗效满意。
Objective To report experience of endovascular aneurysm repair （ EVAR ） with Endurant stent-graft for abdominal aortic aneyrysm. Methods Between May, 2010 and May, 2011, 19 patients underwent EVAR with Endurant stent-graft at Department of Vascular Surgery, Peking Union Medical College Hospital. Clinical and morphological characteristics, operative result, peri-operative complications and follow-up data were reported. Results Procedures were successful in all these 19 cases, among those 9 were with complicated anatomical alterations. There were no type I , III and IV endoleak found immediately after procedure, while 4 cases were found with type II endoleak. Major adverse event during the 30-days after operation included： consumption coagulopathy, myocardial infarction combined with heart failure, wound infection or hematoma. All cases were followed-up from 1 to 12 months. No death occurred. Eight cases had at least one CT angiography. Five cases showed aneurism shrink, the remaining 3 cases showed aneurism diameter did not change. One case suffered from occlusion of unilateral iliac limb artery obliteration, and was treated by fern-fern graft bypass. One case had secondary type I B endoleak, without increase of aneurysm diameter. Conclusions EVAR with Endurant stent-graft is safe and effective. Some complicated anatomic cases could be treated successfully with Endurant stent-graft.
出处
《中华普通外科杂志》
CSCD
北大核心
2012年第3期177-180,共4页
Chinese Journal of General Surgery
关键词
主动脉瘤
腹
人工血管
血管成形术
内漏
Aortic aneurysm,abdominal
Blood vessel prosthesis
Angioplasty
Endoleak
