支架型人工血管腔内治疗复杂主动脉瘤

目的：总结15例应用支架治疗复杂动脉瘤的初步经验。方法：Ⅲ型夹层动脉瘤者主动脉极度扭曲1例；破口在弓部的Ⅲ型夹层动脉瘤1例，需先行左右颈-颈和左右腋．腋动脉人工血管搭桥后再封闭左侧颈总动脉和锁骨下动脉：Ⅲ型夹层动脉瘤近侧破口来自于变异发出的右锁骨下动脉1例；Ⅲ型夹层动脉瘤合并肠系膜上动脉几乎完全闭塞和肠缺血1例；Ⅲ型夹层动脉瘤真假腔难判断者4例；腹主动脉瘤瘤颈长度〈1cm需开窗型支架治疗1例；破裂腹主动脉瘤1例：5枚支架治疗胸腹主动脉瘤1例；腹主动脉瘤瘤颈夹角为90。2例；主动脉溃疡紧邻腹腔动脉，需开窗型支架开窗型人工血管治疗1；肝动脉瘤腹腔动脉瘤合并动静脉瘘1例。结果：15例病人经支架治疗均获得成功。结论：支架型人工血管治疗复杂动脉瘤为微创方法，但需严密设计。

Stent-grafts in treating complicated aneurysms

Objective To summarize our experience of grafts stenting technique in treating complicated aneurysms. Methods Fifteen patients with various types of complicated aneurysms were treated by stenting. Of them, 8 were dissecting aortic aneurysms, 4 infrarenal abdominal aortic aneurysms, 1 origenated from the descending aorta extending to the abdominal aorta forming a huge aneurysm, 1 aortic ulcer near the celiac trunk, and 1 celiac trunk aneurysm combined with A-V shunt of the splenic artery. The proximal intimal entries of dissecting aortic aneurysms were sealed. Abdominal aortic aneurysms were excluded using bifurcate stent-grafts. Results Stent-grafts were successfully performed in all cases. Conclusions Stent-grafting is a minimally invasive and safe procedure, and precise designing should be emphasized to obtain satisfactory results.