“烟囱”技术在主动脉弓病变腔内修复术中的应用

目的：探讨“烟囱”技术在主动脉弓病变腔内修复术中应用的方法及疗效。方法：回顾性统计2010年8月至2014年8月应用“烟囱”技术处理主动脉弓病变的25例患者的方法、结果和术后并发症等。结果：本组25例主动脉弓病变腔内修复技术中应用了“烟囱”技术，男性18例，女性7例，年龄38~78(65±5.8)岁。针对左颈总动脉的“烟囱”技术5例，针对左锁骨下动脉的“烟囱”技术20例。25 例患者均获得技术成功。3例术后即刻造影提示少量I型内漏，未处理，术后1个月复查内漏消失；2例患者出现左上肢乏力，其中1例伴头晕，随访过程中逐渐恢复，无肢体缺血坏死。所有“烟囱”支架均通畅，无主动脉覆膜支架移位、内漏等并发症。结论：“烟囱”技术为近端锚定区不足的主动脉弓部病变提供了完全腔内微创治疗的方法，短期随访结果满意。

Application of "chimney graft" technique for thoracic endovascular aneurysm repair in aortic arch lesions

Objective: To explore the safety and efficacy of “chimney graft” technique during thoracicendovascular aneurysm repair (TEVAR) in aortic arch lesions.Methods: Th e methods, results and the incidence of complications in 25 patients, who received“chimney stent” therapy for aortic arch disease, were reviewed and analyzed.Results: From August, 2010 to August, 2014, 25 aortic arch lesions were treated by TEVAR with“chimney stent”, 18 patients were male and 7 were female. The average age was 38–78(65±5.8)years old. Five patients received “chimney stents” for left common carotid artery, while 20 patientsreceived “chimney stent” for left subclavian artery. Three cases showed small amount of Type Ileak under immediate postoperative angiography without treatment. The leak was disappeared1month later. Two patients appeared left upper limb weakness and one of them showed dizzinessssimultaneously. Both of them recovered gradually in follow-up process. Th ere was no limb ischemiaor necrosis. Th e locations of aortic and “chimney stent” were stable without any migration and leakcomplications.Conclusion: “Chimney graft” technique is a safe and effective treatment for aortic arch lesions dueto lack of proximal anchoring zone. The follow up results in a short-term is satisfied.