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杂交技术治疗胸腹主动脉瘤和夹层
引用本文:张宏鹏,郭伟,刘小平,贾鑫,熊江,马晓辉. 杂交技术治疗胸腹主动脉瘤和夹层[J]. 中华医学杂志(英文版), 2013, 126(4): 620-625
作者姓名:张宏鹏  郭伟  刘小平  贾鑫  熊江  马晓辉
作者单位:Chinese PLA general hospital,Chinese PLA general hospital,Chinese PLA general hospital,Chinese PLA general hospital,Chinese PLA general hospital,Chinese PLA general hospital
摘    要:
Background Hybrid procedures including debranching of visceral and renal arteries followed by endovascular exclusion of the thoracoabdominal aortic aneurysm (TAAA) have recently been proposed as a less...

关 键 词:动脉瘤  混合  程序  平均年龄  夹层  血管造影  CTA  主动脉

Hybrid Procedures for Thoracoabdominal Aortic Aneurysms and Dissections
ZHANG Hong-peng , GUO Wei , LIU Xiao-ping , JIA Xin , XIONG Jiang , MA Xiao-hui. Hybrid Procedures for Thoracoabdominal Aortic Aneurysms and Dissections[J]. Chinese medical journal, 2013, 126(4): 620-625
Authors:ZHANG Hong-peng    GUO Wei    LIU Xiao-ping    JIA Xin    XIONG Jiang    MA Xiao-hui
Affiliation:Department of Vascular Surgery, Chinese People's Liberation Army General Hospital, Beijing 100853, China
Abstract:
Background Hybrid procedures including debranching of visceral and renal arteries followed by endovascular exclusion of the thoracoabdominal aortic aneurysm (TAAA) have recently been proposed as a less invasive alternative to conventional TAAA surgery.This study aimed to evaluate the immediate and long-term outcomes of hybrid procedures for TAAA in high-risk patients.Methods Between September 1998 and May 2012,32 high-risk TAAA patients (five females,median age 61.5 years)underwent hybrid procedures at a single institution.Simultaneous approach and staged approach were performed on the basis of patients' conditions.Follow-up computed tomography angiography (CTA) was routinely performed before discharge and at 6,12 months and annually thereafter.Results Procedural success was achieved in all cases.The median hospital stay was (21.5±2.3) days,and the median procedure time was (420±31) minutes.Blood loss averaged (2100±261) ml.A total of 124 visceral artery bypasses was performed.Two patients (6.3%) died within 30 days.One patient exhibited complete paraplegia (3.1%).The visceral graft patency was 96.1% at 3 years.All-cause survival rates were 93.8%,87.5%,81.3% and 53.1% at 1,2,3 and 5 years,respectively.No patient died due to aortic events.The freedom rates from aortic events were 96.9%,93.6%,87.5%,68.8% at 1,2,3 and 5 years,respectively.Conclusions The results of visceral hybrid repair for high-risk patients with complex TAAAs are encouraging.However,the procedure is still a significant physiological insult to patients.Until branched and fenestrated endovascular repair become more common,hybrid procedure will continue to have a role in high-risk patients.
Keywords:hybrid procedure  thoraeoabdominal aortic aneurysm  endovascular aortic repair," dissection," stent-grafi
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