“烟囱”技术在胸主动脉夹层动脉瘤腔内治疗中的应用

目的 探讨“烟囱”技术在胸主动脉夹层动脉瘤的腔内治疗中的适应证、技术要点及并发症的预防.方法 回顾性分析2010年～2012年我科采用“烟囱”技术治疗4例胸主动脉夹层动脉瘤患者的临床资料,其中破口累及左锁骨下动脉3例,累及左颈总动脉1例.结果 4例患者支架均释放准确,“烟囱”支架通畅.1例患者释放支架后即刻造影提示少量Ⅰ型内漏,术后CT血管造影复查未见明确内漏;1例术后第2天出现精神差、嗜睡,左侧肢体肌力较对侧减退,给予抗凝活血药物治疗1周后左侧肢体肌力恢复.随访6～12个月,均未出现支架闭塞或严重狭窄.结论 “烟囱”技术通过完全腔内方法重修分支血管,实现了微创腔内治疗.

The application of chimney technique in the endovascular treatment of thoracic aortic dissection

Objective To evaluate the indications, technique points and prevention of complication for chimney technique in the endovascular treatment of thoracic aortic dissection. Methods The clinical data of 4 patients with thoracic aortic dissection treated by endovascular treatment with chimney technique from 2010 to 2012 were analyzed retrospectively. The tear of dissection involved the left common carotid artery in 1 case, while involved the left subclavian artery in 3 cases. Results All of the stents were released accurately and patency. 1 case was indicated a small amount of type I endoleak by angiography soon after eluting the stent, however, postoperative CT angiography didn’t show obvious endoleak. One case suffered a poor spirit, drowsines and strength loss of left limb muscle compared with the contralateral side on 2-day after operation. The condition recovered by using anticoagulant medication after one week. During the follow-up time of 6～12 months, no severe stenosis nor occlusion occurred. Conclusion Chimney technique is a minimally invasive treatment for endovascular reconstruction of branch arteries.