主动脉疾病腔内介入治疗15例体会

目的: 总结腔内修复术治疗主动脉疾病的经验、体会,探讨主动脉疾病介入治疗的适应证及操作要点。方法: 在气管插管全麻下进行,8例主动脉夹层患者采用直径34~42 mm覆膜支架封堵降主动脉近端破裂口,其中1例支架覆盖左锁骨下动脉;6例腹主动脉瘤中1例采用直型支架腔内隔绝,其余均采用分叉型支架经双股动脉置放成功;1例早期主髂动脉硬化性闭塞症患者采用预先扩张主髂动脉狭窄段,置入分叉型人工血管支架。结果: 全组无手术死亡,腔内隔绝术后造影显示假腔及瘤腔均消失;2例I型内漏,随访半年后消失,假腔内部分血栓形成。1例主动脉夹层患者手术后1年突然死亡。结论: 腔内隔绝术治疗主动脉疾病安全、可行、有效,适应证不断扩展。

Endovascular intervention on 15 patients with aorta disease

Objective:To summarize the experience of endovascular exclusion on aortic diseases,and investigate the intervention therapeutic indications and operational essentials about aortic diseases.Methods:Tracheal intubation anesthesia was employed in all 15 patients.The endovascular polyester-covered stent graft exclusion was used to obturate the tear entry on the proximal end of descending aorta in 8 patients with dissecting aneurysm of aorta and the left subclavian artery was obturated in 1 patient.One in 6 abdominal aneuryoms was placed with the straight endovascular polyester-covered stent graft exclusion while other patients were placed with crotched stent graft through double femoral artery.The percutaneous transluminal balloon dilatation of crotched stent graft placement was performed in 1 patient with the early aortoilion arterial occlusive disease.Results:There were no death in all treated patients,and pseudocele and cavity of aorta were not found by phlebography after endovascular exclusion.Type I internal hemorrhage was detected in 2 ptients who were followed up 6 months,and the pseudocele of aorta thrombosis was found partly.One patient died abruptly 1 year later after operation.Conclusion:It is safe,feasible,effective in endovascular exclusion on aortic diseases,and it could replace traditional operation gradually.Its therapeutic indications could be increased continuously.