覆膜支架治疗降、腹主动脉假性动脉瘤13例分析

目的探讨覆膜支架治疗主动脉假性动脉瘤的疗效.方法回顾性分析应用覆膜支架治疗的13例降、腹主动脉假性动脉瘤患者的病例资料,并随访观察其疗效.结果8例覆膜支架植入后假性动脉瘤即刻被完全隔绝.5例覆膜支架植入后有内漏,其中1例吻合口漏致降主动脉假性动脉瘤患者补充植入一短段cuff覆膜支架后内漏消失;4例行球囊扩张,2例扩张后内漏消失,2例仍有少许内漏,但3个月后复查证实内漏完全消失.2例失访,其余11例随访4～30个月,平均18.6个月,1例死于上消化道大出血,其余病例覆膜支架均通畅,无移位,瘤腔无扩大.结论应用覆膜支架治疗降、腹主动脉假性动脉瘤是行之有效的治疗方法,且创伤小,恢复快,尤其适用于不能耐受传统手术治疗者,近期疗效满意,远期疗效尚待进一步观察.

Treatment of descending and abdominal aortic pseudoaneurysm with stent-graft: a report of 13 cases

Objective To explore the effects of stent-graft on treating descending and abdominal aortic pseudoaneurysms. Methods Seven cases of descending and 6 cases of abdominal aortic pseudoaneurysms were treated with stem-graft, aging from 28 to 72 years, average 59 years. Results Eight cases of aortic pseudoaneurysms were completely excluded after the procedure. Slight leakages were found in 5 cases. Leakages disappeared through balloon dilatation in 2 cases, and one more stent-graft cuff implanted in 1 case. Slight leakages were still presented after dilatation in the other 2 cases, however, the leakages disappeared 3 months later, Eleven cases were followed up from 4 to 30 months with a mean of 18.6 months. One case died of massive hemorrhage from upper digestive tract 5 months after operation. The stent-grafts of other cases maintained patent, and no migration occurred. The diameter of the pseudoaneurysm of all cases did not increased. Conclusions It is safe, effective and mini-invasive to use stent-graft in the treatment of descending and abdominal aortic pseudoaneurysm, however, the long-term investigation is needed.