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论著:分叉型一体式覆膜支架腔内治疗肾下型腹主动脉瘤的疗效
Endovascular Repair of Infrarenal Abdominal Aortic Aneurysm with Unibody Bifurcated Stent Grafts
史伟浩 余波 王巍
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作者单位:复旦大学附属华山医院血管外科
中文关键字:分叉型一体式覆膜支架;腹主动脉瘤;腔内修复
英文关键字:Unibody bifurcated stent grafts;Abdominal aortic aneurysm; Endovascular repair
中文摘要:目的:探讨应用分叉型一体式覆膜支架腔内治疗腹主动脉瘤和髂动脉瘤的疗效。方法:回顾分析采用分叉型一体式覆膜支架治疗的20例肾下型腹主动脉瘤和髂动脉瘤患者的临床资料。结果:20例患者植入分叉型一体式覆膜支架的手术成功率达100%,无围手术期死亡患者,且所有患者均未出现各类缺血性并发症。8例患者术后存在少量内漏(6例Ⅰ型内漏,2例Ⅲ型内漏),1周后内漏消失;1例患者术后发生急性肝肾功能不全,经内科治疗1周后恢复;2例患者术后出现腹股沟切口淋巴瘘,经换药愈合。平均随访15个月,所有患者未出现新的内漏和支架移位。1例患者术后1年在左侧分支支架内形成血栓,左侧髂动脉局部无血流,经导管接触溶栓治疗1 d后实现血管再通。结论:应用分叉型一体式覆膜支架腔内治疗腹主动脉瘤安全有效。
英文摘要:Objective: To summary the clinical experience in applying unibody bifurcated stent grafts for endovascular treatment of abdominal aortic aneurysm and iliac aneurysm. Methods: From February 2009 to March 2012, unibody bifurcated stent grafts had been applied in the treatment of 20 patients suffering from infrarenal abdominal aortic aneurysm and iliac aneurysm. Their clinical data were analyzed. Results: A total of 100% success rate of stent implantation has been achieved without perioperative deaths and any ischemic complications; postoperative endoleak occured in 8 cases(6 cases of type I endoleak, 2 cases of type III endoleak), and endoleak disappeared in all of them within one week; acute liver and kidney dysfunction occurred in one case and it was relieved after medical treatment for one week; groin incision lymphatic fistula occurred in two cases and was healed by dressing change. Patients have been followed up for an average period of 15 months. No endoleak and stent migration occurred. Conclusions: Applying unibody bifurcated stent graft for endovascular treatment of abdominal aortic aneurysm is less invasive, more convenient in operation and shows high stability without the risk of long term migration. Therefore, this method is especially suitable for abdominal aortic aneurysm with narrow abdominal aortic bifurcation.
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