腔内人造血管内支撑术治疗腹主动脉瘤

目的 评价腔内人造血管内支撑术治疗腹主动脉瘤的早期临床疗效。方法 自１９９８年２月至１９９９年２月,根据６例腹主动脉瘤患者三维重建螺旋ＣＴ和动脉造影结果,于术前对每个腹主动脉瘤近远端的瘤颈长度、直径和角度,以及动脉瘤和髂总动脉、髂外动脉本身的直径等主要参数进行测量,动脉瘤直径为４．６～８．０ｃｍ,平均６．３ｃｍ;肾动脉下腹主动脉直径为１．８～２．２ｃｍ,平均２．０ｃｍ;近端瘤颈长度为２．５～３．５     

Endovascular abdominal aortic aneurysm repair: how many patients are eligible for endovascular repair?

PURPOSE: The purpose of this study was to determine how many patients with abdominal aortic aneurysm (AAA) are eligible for endovascular abdominal aortic aneurysm repair (EVAR). MATERIALS AND METHODS: We retrospectively reviewed computed tomography (CT) angiograms obtained between January 2002 and June 2003 in 182 patients with suspected AAA. Indication for surgical or endovascular treatment was based on clinical and radiological criteria. The percentage of patients eligible for EVAR was evaluated. RESULTS: Out of a total of 182 patients with suspected AAA studied by CT angiography, after combined radiological-surgical assessment, 130 were considered eligible for surgical or endovascular treatment (71.4%). EVAR was indicated in 51 patients (39.3%, group A) and surgical repair was indicated in 79 patients (60.7%, group B). The reasons for ineligibility for EVAR were the following: unfavourable anatomy of the proximal neck in 41 patients (51.9%), diameter of the aneurysm sac >7 cm in 13 patients (16.4%), markedly tortuous/dilated iliac axis in six patients (7.6%), age <65 years in 17 patients (21.5%) and patient refusal in two cases (2.5%). There were no statistically significant differences in aneurysm diameter (52.7+/-0.8 versus 49.8+/-1.2 mm, p=ns), patients' age (73.2+/-1.2 versus 70.6+/-2.02 years, p=ns) or proximal neck length (2.95+/-1 versus 3.03+/-1.2 cm, p=ns) between groups A and B. CONCLUSIONS: Endovascular repair of abdominal aortic aneurysms through the placement of aortic stent-grafts has now become a viable alternative to open surgery. In recent years, the number of patients treated with EVAR has steadily risen as a result of increased physician experience, availability of new and more versatile devices and improvements in noninvasive imaging techniques. Unfavourable neck anatomy is the primary factor for exclusion from endovascular repair.     

Lessons learnt from the EUROSTAR registry on endovascular repair of abdominal aortic aneurysm repair.

OBJECTIVE: The EUROSTAR project is a multicentred database of the outcome of endovascular repair of infra-renal aortic aneurysms. To date 92 European centres of vascular surgery have contributed. The purpose of the article here is to review the medium term (up to 4 years) results of endovascular aneurysm repair as reported to Eurostar. PATIENTS AND METHODS: Patients intended for endovascular aneurysm repair were notified to the EUROSTAR Data Registry Centre before treatment in order to eliminate bias due to selective reporting. The following data was collected on all patients: (1) their demographic details and the anatomical characteristics of their aneurysms, (2) details of the endovascular device used, (3) procedural complications and the immediate outcome, (4) results of contrast enhanced CT imaging at 3, 6, 12 and 18 months after operation and at yearly intervals thereafter, (5) all adverse events. Life table analysis was performed to determine the cumulative rates of: (1) death from all causes, (2) secondary intervention. Risk factors for rupture and late conversion were identified by regression analysis. RESULTS: By July 2000, 2862 patients had been registered and their median duration of follow-up was 12 mo (range 0-72). Successful deployment was achieved in 2812 patients with a perioperative (30 day) mortality of 2.9%. In 2464 patients enrolled by March 2000 late rupture of the aneurysm occurred in 14 patients for an annual cumulative rate of 1%. The significant factors were proximal type I endoleak (P=0.001), midgraft (type III) endoleak (P=0.001), graft migration (P=0.001) and post-operative kinking of the endograft (P=0.001). Forty-one patients had late conversion to open repair for an annual cumulative rate (risk) of approximately 2.1%. Risk factors (indications) for late conversion were: proximal type I endoleak (P=0.001), midgraft (type III) endoleak (P=0.001), type II endoleak (P=0.003), graft migration (P=0.001), graft kinking (P=0.001) and distal type I endoleak (P=0.001). CONCLUSIONS: Endovascular repair of infra-renal aortic aneurysms using the first and second-generation devices that predominated in this study was associated with a risk of late failure of 3% per year, based upon an analysis of observed primary endpoints of rupture and conversion. Eurostar continues to provide responsible evaluation of the technique for the benefit of both physicians and the industry.     

螺旋CT在腔内隔绝术治疗腹主动脉瘤术前评估中的价值

目的探讨螺旋ＣＴ（ｓｐｉｒａｌＣＴ，ＳＣＴ）在腔内隔绝术（ＥＶＧＥ）治疗腹主动脉瘤（ＡＡＡ）术前评估中的价值。方法以ＳＣＴ扫描了４１例ＡＡＡ患者，资料经计算机处理进行ＳＣＴ图像重建（ＣＴＡ），所用技术主要为表面阴影遮盖技术（ＳＳＤ）、最大信号强度投影（ＭＩＰ）、多平面重建（ＭＰＲ）及曲面重建（ＣＰＲ）技术，少数夹层动脉瘤应用模拟的内窥镜技术。测量远近端瘤颈长度及直径，瘤体的大小、形态及与分支动脉的关系，双髂动脉形态、口径及肾动脉开口到髂动脉分叉水平的自然长度。根据ＥＶＧＥ手术适应证的要求，选择９例患者行ＥＶＧＥ。结果据上述参数选定移植物的规格、型号，经术中证实与需求相符。结论ＣＴＡ图像质量高，无创、快速、准确，可获得ＥＶＧＥ术前评估所需全部参数，具有良好的应用价值     

腹主动脉瘤腔内隔绝术后神经缺血性损伤

目的：探讨在腹主动脉瘤（AAA）腔内隔绝术（EVE）中神经缺血性损伤的发生原因及防治。临床资料：我科在施行AAA EVE中遇到1例术后发生神经缺血性损伤。患者为Ⅱa型AAA，选用Talent分叉型移植物行EVE，手术顺利。术后出现双侧股部酸痛不适、乏力，伴右侧屈髋无力。行肌电图检查提示双侧腓总神经、胫神经、H反射传导速度均减慢，双侧股神经未能引出动作电位。给予甲钴胺0.5mg肌内注射，隔日1次，地巴唑10mg3次/d，并辅以高压氧治疗和股四头肌功能锻炼。治疗2个月后患者股部疼痛、乏力逐步缓解，无明显功能障碍。复查下肢肌电图无明显改善。结论：AAA EVE后可能会发生脊髓的缺血性损伤，但发生率很低，术中封闭腰动脉是导致脊髓缺血的原因。脊髓缺血性损伤早期治疗最为重要，后期的神经营养治疗和功能锻炼也可以改善部分症状。     

Endovascular repair of ruptured abdominal aortic aneurysm: feasibility and impact on early outcome

PURPOSE: Open repair of ruptured abdominal aortic aneurysms (AAAs) still has a high associated mortality rate. The impact of the introduction of endovascular treatment on the early outcomes of ruptured AAAs was examined at a single institution. The suitability of acute endovascular aneurysm repair (EVAR) in patients with ruptured AAAs was also assessed. MATERIALS AND METHODS: Retrospective review was conducted in 39 consecutive patients treated for ruptured AAA from 2001 to 2004. The patients were divided into 15 who underwent open repair from 2001 to 2002 (group I) and 24 who were treated with open repair (n=13; 54%) or endovascular repair (n=11; 46%) from 2003 to 2004 (group II). Hospital charts and computed tomographic scans were reviewed to evaluate the feasibility of EVAR. RESULTS: Age, sex, and aneurysm size were similar between the two groups. The 30-day mortality rates were 53% in group I and 8% in group II (P=.003). Median procedure times were shorter in the patients who underwent EVAR. Intensive care unit stay and hospital stay were 22.0 days+/-29.6 and 29.7 days+/-33.8, respectively, in group I, and 5.6 days+/-4.4 and 16.1 days+/-10.9, respectively, in group II (P<.03). Eleven patients were found ineligible for EVAR as a result of an unsuitable neck (n=5) or iliac arteries (n=3) or both (n=3). No graft failure was detected during follow-up. CONCLUSIONS: After introduction of acute EVAR, a total of 46% of patients with ruptured AAAs were treated with the procedure. Potentially, 54% of patients could have been suitable for EVAR. Endovascular stent-graft implantation has significantly improved outcomes in ruptured AAAs and may therefore be beneficial in the overall treatment strategy in these patients.     

Morphological and functional modifications of the aneurysm-endograft complex following endoluminal treatment of abdominal aortic aneurysms

PURPOSE: The aim of the study was to evaluate quantitatively the main morphological changes of the abdominal aortic aneurysm (AAA)-endograft (EG) complex following endovascular repair of infrarenal AAA and to evaluate the functional consequences of these changes in terms of rate of complications (endoleaks and thrombosis). We also assessed whether these morphological and functional changes were related to the size of the AAA and to the type of EG used. MATERIALS AND METHODS: Eighty-five patients (M/F=82/3; mean age at time of operation 70.5+/-3.5 years, range 49.9-89.6 years) who underwent endovascular treatment of infrarenal AAA between April 1997 and October 2004 with a follow-up of at least 1 month were considered. All images of 408 preoperative and postoperative computed tomography (CT) studies were reviewed. Statistical analysis was performed with log-rank test on the 85 patients grouped according to AAA diameter <50 mm or < or =50 mm, and on 75 patients grouped according to EG device used (AneuRx, Talent or Excluder). RESULTS: Morphological and dimensional changes involved the diameter (six cases) and length (14 cases) of AAA proximal neck, diameter (36 cases) and length (51 cases) of the aneurysm sac and shape of the stent-graft (47 cases). The prevalence of endoleaks was 37.6% whereas endoluminal thrombosis was observed in 27.1% of patients. AAA growth was significantly correlated (p=0.002) with the preprocedural diameter of the aneurysm sac whereas shrinkage was significantly correlated (p=0.0005) with the EG used. CONCLUSIONS: AAA growth was correlated with the diameter of the aneurysm sac while shrinkage was correlated with the EG used. During follow-up after endovascular repair, patients require careful evaluation of the morphological and dimensional features of the AAA and EG to promptly identify any changes that can anticipate major complications and even conversion to conventional surgery.     

Elective endovascular treatment of descending thoracic aortic aneurysms and chronic dissections with stent-grafts

PURPOSE: To report our experience of endovascular stent-graft placement in patients with descending thoracic aortic dissections and aneurysms and to evaluate the feasibility, safety, and clinical outcomes of the treatment. MATERIALS AND METHODS: Stent-grafts were placed in the descending thoracic aortas of 23 patients with saccular aneurysms (n = 11) and Stanford type B chronic aortic dissections of the descending thoracic and abdominal aorta (n = 12). All stent-grafts were individually constructed of self-expandable stainless steel stents covered with polytetrafluoroethylene. Vascular access was achieved through the femoral artery in all patients. Clinical status of each patient was monitored and postoperative CT was performed within 1 month of the procedure and at 3-12-month intervals after the procedures. RESULTS: Successful exclusion of the primary entry tears of dissections and the inlets of saccular aneurysms was achieved in all but two patients with aortic dissection. The overall technical success rate was 91.3% (dissection: 10 of 12 = 83%; aneurysm: 11 of 11 = 100%). All patients in whom technical success was achieved showed complete thrombosis and significant decrease in diameter of the thoracic false lumen (preoperative: 5.3 cm +/- 0.9; postoperative: 4.3 cm +/- 0.9; P = .004) or aneurysm sac (preoperative: 5.3 cm +/- 1.7; postoperative: 2.8 cm +/- 2.5; P = .001). In addition, five patients demonstrated complete resolution of the dissected thoracic false lumen (n = 2) and aneurysm sac (n = 3). However, in all patients with aortic dissection, the abdominal aorta was not significantly changed in size (P = .302) and shape and their false lumen flows remained persistent. Immediate postoperative complications were detected in 12 patients (52%); 10 had fever, leukocytosis, and elevation of C-reactive protein, another had wound infection, and another had transient abdominal pain. Three patients died 2, 3, and 12 months after the procedure: one from septic shock, another from underlying mediastinitis, and the other from an unexplained cause. The remaining 20 patients were well after the procedure (1-9 days; mean, 3 days), without any stent-graft-related complications or discomfort (follow up period: 10-65 mo; mean: 25.1 mo +/- 15.6). The cumulative survival rate after the stent graft was 100% at 30 days and 91% at 12 months. CONCLUSIONS: For treatment of aortic dissection and saccular aneurysm of the descending thoracic aorta, endovascular stent-graft repair may be a technically feasible and effective treatment modality.     

Renewed endovascular repair for recurrent acute abdominal aortic aneurysm

The aim of the study was to describe the successful endovascular management of a patient who was admitted urgently with a second episode of acute abdominal aortic aneurysm (AAA) 30 months after emergency endovascular abdominal aortic aneurysm repair (eEVAR) for a ruptured AAA. The patient, an 84 year-old male physician, presented with severe acute abdominal and back pain. Contrast-enhanced computer tomography scanning showed type III endoleak owing to complete disconnection of both graft limbs and the prosthetic main body. Treatment consisted of acute stent-grafting with two bridging stent-grafts to seal the endoleak and reline the graft. The patient is alive and well 6 months postoperatively. This case indicates the need for follow-up after eEVAR, but also that complications can be managed endovascularly.     

腹主动脉复合动脉瘤的腔内隔绝术治疗

目的：讨论复合腹主动脉病变进行腔内隔绝术（EVE）的可行性。方法：1例腹主动脉并存真性、假性和夹层动脉瘤患者，经双侧股动脉切开、肱动脉切开引入贯穿导丝，利用导丝导向技术和牵张技术成功置入模块式支架-人造血管移植物，以隔绝瘤体。结果：腔内隔绝操作技术完全成功，3个瘤体同时被隔绝，未加用任何延伸移植，未出现内漏、移位等并发症，重建血流通畅。结论：本例为EVE扩大适应证提供了经验。     

不使用造影剂的腹主动脉瘤腔内隔绝术

目的：探讨一种不使用造影剂的腹主动脉瘤（AAA）腔内隔绝术（EVE），治疗合并肾功能不全的AAA患者。方法：对3例合并肾功能不全的AAA患者在不使用造影剂条件下实施AAA EVE，并对术前评估内容进行分析。结果：3例患者手术均获成功，2例采用分叉型移植物，1例采用直型移植物。术后随访结果表明，动脉瘤被完全隔绝，无内漏，瘤腔内血栓形成；移植物内血流通畅，周围无异常血充。结论：选择近端瘤颈较长的患者，术前对肾动脉及髂内动脉开口位置等指标进行准确评估，不使用造影剂同样可以完成AAA EVE。     

多层螺旋CT在腹主动脉瘤腔内隔绝术后的随访价值

目的 分析腹主动脉瘤腔内治疗术后的转归及多层螺旋CT(MSCT)随访价值.方法 回顾性总结2000年3月至2006年12月问193例腹主动脉瘤腔内隔绝术后行MSCT检查的结果,并与术前资料对照.结果 193例中发现支架变形、断裂4例,支架闭塞1例、内漏24例、移植物感染2例;瘤体缩小81例,瘤体增大21例,瘤体无变化91例.结论 MSCT是腹主动脉瘤腔内隔绝术术后随访的首选方法 .     

内支架置入术治疗胸腹主动脉瘤的临床评价

目的：探讨胸腹主动脉瘤的ESG治疗临床疗效。方法：对10例患者分别行CTA、MRA、DSA检查和ESG治疗，其中Stanford B型夹层动脉瘤6例，真性腹主动脉瘤2例，肾动脉开口以下腹主动脉瘤2例（行分体式支架），所有病例均采用带膜支架。结果：8例行一体式支架腔内隔绝术，2例行分体式支架腔内隔绝术，均获成功。顺利植入，术后造影提示动脉瘤消失．无内漏发生。患者症状完全消失，全部患者在随访期间均未出现术前症状，未见相关并发症。结论：应用ESG治疗胸腹主动脉瘤安全、有效、创伤小、术后恢复快，长期疗效尚待进一步观察。     

内漏对腹主动脉瘤腔内隔绝术后瘤腔内压力的影响

目的 探讨内漏状态下腹主动脉瘤(AAA)腔内隔绝术(EVE)后瘤腔内压力的变化。方法 通过建立犬AAA EVE后内漏模型，测定内漏存在前后瘤腔内压力的变化。结果 内漏状态下瘤腔内平均动脉压明显升高，而内漏封闭后压力显著下降，且曲线平直。结论 瘤腔内压力曲线可作为评估EVE后瘤壁所受负荷的变化，也可作为判断内漏存在的方法之一。     

Concepts for optimizing stent graft treatment of abdominal aortic aneurysms based on results of animal experiments

PURPOSE: In the endoluminal therapy of abdominal aortic aneurysms, a short proximal aneurysm neck, endoleaks and the large size and stiffness of the introducer systems are responsible for many of the complications and sub-optimal outcomes. The purposes of the present review article is to to suggest strategies to minimize these complications based on the results of experimental studies in animals. MATERIAL AND METHODS: After implanting various types of stents across the renal artery origins, the functional and morphological changes in the kidneys and renal vessels were studied by various authors. In order to prevent progressive widening of the proximal aneurysmal neck and graft dislocation, Sonesson et al. performed a laparoscopic banding around the proximal neck in pigs. To study the effects of endoleaks, Marty, Schurink and Pitton carried out pressure measurements in experimental aneurysms with and without endoleaks. Sakaguchi und Pavcnik developed the "Twin-tube endografts" (TTEG) and the "Bifurcated drum occluder endografts" (BDOEG) and tested them in dogs. RESULTS: Up to 3 months after suprarenal stent placement, Chavan et al. detected no significant fall in the mean inulin clearance in sheep (140 +/- 46 ml/min before, 137 +/- 58 ml/min after). Nasim et al. and Malina et al. reported similar observations with respect to renal function. Suprarenal fixation may result in isolated thrombotic occlusions of the renal arteries and microinfarcts in the kidneys. Mean aortic diameters at the level of banding were significantly smaller in the animals with aortic banding as opposed to those in the control group without banding (8 mm vs 11 mm, p = 0.004). The banding caused a secure proximal fixation of the stent-graft. Persistent endoleaks resulted in significantly higher intraaneurysmal pressures. Although the TTEG and the BDOEG stent-grafts required smaller sheaths, occlusions were observed in 8% (TTEG) and 60% (BDOEG) of the graft limbs. DISCUSSION: Supra-renal fixation of the stent-graft does not significantly affect renal function. Depending partly on the stent-graft-Design, isolated microinfarcts in the kidneys or thrombotic occlusions of the renal arteries may occur. A laparoscopic banding of the aorta at the proximal neck after graft implantation could prevent widening of the proximal neck and graft dislocation with the passage of time. To reduce the incidence of endoleaks, embolization of large branches, particularly those arising from aneurysms without mural thrombus is advisable. Due to the relatively high rate of occlusion of the graft limbs, the TTEG and the BDOEG stent-graft designs still require refinement. A rational application of the results of these animal experimental studies in clinical practice could markedly improve the long-term results of endoluminal stent grafting of abdominal aortic aneurysms.     

Renal perfusion defects after endovascular repair of abdominal aortic aneurysms

PURPOSE: To determine the prevalence of new renal perfusion defects and the association of these events with aneurysm neck atheroma during endovascular stent-graft repair of abdominal aortic aneurysm (AAA). MATERIALS AND METHODS: A retrospective review was performed of 50 patients who underwent AAA repair with bifurcated endovascular stent-grafts without suprarenal components between June 1998 and May 1999. Pre- and postprocedural computed tomographic (CT) angiograms were reviewed to determine the prevalence of new renal perfusion defects. The percent volume of atheroma of the aneurysm neck was determined by three-dimensional volumetric reformation and correlated with prevalence of new postprocedural renal perfusion defects. Follow-up CT angiography was performed between 6 months and 2 years after the procedure and used to evaluate the presence of residual defects and interval changes. RESULTS: Of 50 subjects, 18% (n = 9) had new perfusion defects presumed to be embolic in origin. Follow-up was available for four patients: scarring and cortical thinning consistent with infarction developed in two, whereas the defects resolved in the other two. Analysis of aneurysm neck revealed an average percentage of atheroma of 32% and a range of 0%-73%. In subjects with >/=40% neck atheroma, the prevalence of new renal perfusion defects was 45.4% (five of 11), compared to 10.3% (four of 39) in subjects with <40% neck atheroma. This difference was significant (P =.0170). CONCLUSIONS: In this series, the frequency of renal embolic events associated with AAA endovascular repair was 18%. Prevalence of renal embolic perfusion defects was shown to correlate with volume of aneurysm neck atheroma.     

Epidemiology of aortic disease: aneurysm, dissection, occlusion

The physiological infrarenal aortic diameter varies between 12.4 mm in women an 27.6 mm in men. As defined, an aneurysmatic dilatation begins with 29 mm. According to that, 9% of all people above the age of 65 are affected by an abdominal aortic aneurysm (AAA). Compared with the female sex, the male sex predominates at a rate of about 5:1. The disease is predominant in men of the white race. In black men, black and white women the incidence of AAA is identical. 38 to 50 percent of the AAA patients (patients) suffer from hypertension, 33 to 60% from coronary, 28% from cerebrovascular and 25% from peripheral occlusive disease. The AAA expansion rate varies between 0.2 and 0.8 cm per year and is exponential from a diameter of 5 cm on. In autopsy studies, the rupture rates with AAA diameters of < 5 cm, between 5.1 and 6.9 cm, and of > 7 cm were below 5%, 39% and 65%, respectively. 70% of the AAA patients do not die of a rupture, but of a cardiac disease. Serum markers, such as metalloproteinases and procollagen peptides are significantly increased in AAA patients. Thoraco-abdominal aneurysms (TAA) make up only 2 to 5% of all degenerative aneurysms. 20 to 30% of the TAA patients are also affected by an AAA. 80% of the TAA are degenerative, 15 to 20% are a consequence of the chronic dissection--including 5% of Marfan patients--, 2% occur in case of infections and 1 to 2% in case of aortitis. The TAA incidence in 100,000 person-years is 5.9% during a monitoring period of 30 years. In case of TAA, an operation is indicated with a maximum diameter of 5.5 to 6 cm and more and, in case of a Marfan's syndrome (incidence of 1:10,000), with a maximum diameter of 5.5 cm and more. With regard to aorto-iliac occlusive diseases, there are defined 3 types of distribution. Type I refers to the region of the bifurcation itself. Type II defines the diffuse aorto-iliac spread of the disease. Type III designates multiple-level occlusions also beyond the inguinal ligament. Type I patients in most cases are female and more frequently suffer from hyperlipidaemia, while Type II patients are affected by hypertension and diabetes. Compared to Type II patients, Type I patients have a life expectancy that is 10 years higher. Type I and Type II patients often suffer from a pelvic claudication and, unlike Type III patients, are more frequently affected by arterio-arterial embolisms.     

Analysis of initial CT findings after endovascular repair of abdominal aortic aneurysm.

PURPOSE: To determine the spectrum and frequency of specific computed tomographic (CT) findings in the acute period after endovascular repair of abdominal aortic aneurysm (AAA). MATERIALS AND METHODS: CT images obtained 1--3 days after endograft placement were evaluated in 88 patients. The images were analyzed for stent position, appearance of endograft components, perigraft leak, and postoperative findings including air and acute thrombus within the aneurysm and air surrounding the femoral-femoral bypass graft. Findings that could be misinterpreted as perigraft leak were evaluated. RESULTS: Fifteen (17%) of 88 patients had perigraft leak in the acute postoperative period. The bare segment of the proximal self-expanding stent covered one or both renal arteries in 54 (61%) patients. One patient had CT evidence of renovascular compromise. Postoperative air was within the aneurysmal sac in 51 (58%) patients and surrounded the femoral-femoral bypass graft in 67 (94%) of 71 patients in whom the grafts were evaluated with CT. Mottled attenuation within the aneurysmal sac was seen in 50 (57%) patients. Forty-six (52%) patients had calcifications within longstanding thrombus. In 31 (35%) patients, findings that could have been misinterpreted as perigraft leak were identified. CONCLUSION: Accurate analysis of CT findings after endovascular AAA repair requires careful review of all available CT images (preprocedural and pre- and postcontrast) and clear understanding of specific stent-graft components and placement.     

腔内隔绝术治疗腹主动脉瘤(附2例报告)

目的：探讨腔内隔绝术治疗腹主动脉瘤（AAA）的方法、疗效、并发症及存在的问题。方法：2例高龄、多病并存的AAA患者在全订及动脉造影的监控下，植入血管内支架－聚酯移植物复合体，对AAA进行腔内隔绝术。结果：术后定期复查彩超、CT及血管造影显示支架通畅，无移位、扭曲、支架外壁与瘤腔间充满血栓，未发现搏动的肠系膜下动脉及腰动脉，未发现渗漏。AAA外径无变化。患者腹部搏动性肿块消失。结论：腔内隔绝术治疗AAA避免了外科手术的各种缺点，具有简便、安全、疗效确定等优点。