血管内支架移植物治疗胸-腹主动脉瘤

目的　评价内支架移植物 (ESG)植入术治疗胸、腹主动脉瘤的有效性和安全性。方法　 2 8例胸、腹主动脉夹层动脉瘤 (AD或AAA) ,全麻下行血管内支架移植物治疗 ,其中 5例AD植入TALENT移植物 ,9例植入国产ESG ;7例AAA植入Zenith和TALENT分叉型ESG ,7例植入国产ESG。结果　 2 5例动脉假腔及动脉瘤得到有效隔绝。2例AD封堵失败 ;1例AAA移植物遮盖右肾动脉开口 ,术后肾体积缩小 ;1例AAA因多器官衰竭死亡。平均随访 18.5± 15 .1个月( 1～ 5 9个月 ) ,2 5例生活及工作情况良好。结论　ESG植入术可有效治疗StanfordB型AD和肾下AAA ;严格掌握适应证有助于减少并发症

Endovascular stent-graft exclusion for treatment of thoracic and abdominal aneurysms

Objective To evaluate the efficacy and safety of endovascular stent-graft exclusion in the treatment of thoracic and abdominal lesions. Methods Total 28 patients (24 males and 4 females, aged from 29 to 87 years, mean 60.4 years old) including 14 cases of thoracic aortic dissection (AD), 1 case of thoracic-abdominal aortic aneurysms, 13 cases of abdominal aortic aneurysms (AAA), underwent endovascular stent-graft exclusion under general anaesthesia. TALENT and home-made stent-grafts were used respectively in 5 and 9 cases of thoracic aortic dissection. Zenith and/or TALENT bifurcated stent-grafts were used in 14 cases of AAA. Results Twenty-five cases were treated successfully. The mean operation time was 2.1±0.8 hours. In 2 cases of thoracic aortic dissection, 1 case died after failed exclusion. Right renal artery covered by stent-graft occurred in 1 case. Another AAA case died of mutiorgen function failure. The mean time staying in hospital was 14±3.6 days. One week later, CT angiography reexamine showed real lumen enlarged and false lumen collapse in 12 cases of thoracic aortic dissection, no endoleak and stent-graft disposition occurred in all AAA patients except one case of right kidney becoming smaller. The 25 successfully treated cases were followed up for 1 to 59 months and in better condition. Conclusion Stanford B type AD and infrarenal AAA can be treated by endovascular stent-graft exclusion effectively and safely.