腔内覆膜支架置放修复周围动脉损伤

目的：探讨腔内覆膜支架置放修复周围动脉损伤的适应证.评估腔内覆膜支架置放修复周围动脉损伤的可行性及疗效.方法：回顾2004年5月至2006年1月,6例行腔内覆膜支架置放术的周围动脉损伤患者之临床资料.肾动脉损伤（假性动脉瘤）1例,髂总动脉损伤（假性动脉瘤伴动静脉瘘、局灶性穿通伤）2例,股动脉损伤（均为假性动脉瘤）2例,股浅动脉损伤（假性动脉瘤）1例.其中穿通性损伤4例（医源性3例、刀刺伤1例）,钝性损伤2例.结果：所有患者均取得技术成功,损伤血管均被完全隔绝.除1例肾动脉损伤患者发生内漏外,某余术后随访2～18个月,肾动脉支架内漏1个月后消失.所有患者未发现支架内严重再狭窄（＞50%）.结论：腔内覆膜支架置放治疗周围动脉损伤是安全、可行的,在严格而准确地掌握适应证的基础上,施行血管腔内覆膜支架置放术治疗周围动脉损伤,具有较传统手术创伤小、安全性高及恢复快的优点.

Endovascular covered stent-graft repair of traumatic arterial lesions

Objective: To investigate the feasibility,efficacy and indications of endovascular covered stent-graft in repairing traumatic arterial lesions.Methods: Patients with blunt or penetrating(including iatrogenic) peripheral arterial injuries between May 2004 and January 2006 were retrospectively studied.Endovascular covered stent-graft repair of peripheral arterial lesions was performed in 6 patients,including one case of renal pseudoaneurysm,one iliac pseudoaneurysm and arteriovenous fistulas,one iliac focal laceration,two common femoral pseudoaneurysms and one superficial femoral pseudoaneurysm.Results: All cases were technically successful.Completion arteriography revealed complete exclusion of all lesions,except for one minimal proximal stented graft leak in the renal pseudoaneurysm.All patients continued to have patent grafts with a follow-up ranging from 2 to 18 months(mean 8.5 months).The proximal leak initially present in a stented graft vanished after 1 month.Conclusion: Endovascular covered stent-grafts offer an effective,feasible and less invasive technique in treating traumatic arterial lesions on the basis of accurately defining the management indications.