主动脉弓原位开窗术的应用和进展

主动脉弓腔内修复术的重点与难点在于完全隔绝病变部位的同时维持弓上分支的血流，原位开窗技术可以快速、有效地重建弓上分支血流。原位开窗技术的应用逐步扩大了胸主动脉腔内修复术治疗主动脉弓疾病的适应证。随着腔内技术的发展与适合主动脉弓部器械的出现，单分支开窗到三分支开窗的临床应用都取得了满意的短中期结果。开窗的方式主要包括机械方法和物理方法，机械方法是利用各种针具穿刺破膜，而物理方法主要是应用激光和射频进行热能破膜。本文介绍了原位开窗术治疗主动脉弓疾病的应用和进展。

Application and progress of in situ fenestration of aortic arch

The focus and difficulty in endovascular aortic arch repair is how to maintain the blood flow of the supra-aortic branches with total isolation of the lesion. In situ fenestration can quickly and effectively reconstruct the blood flow of the supra-aortic branches, and its application has gradually expanded the indications of thoracic endovascular aortic repair in the treatment of aortic arch diseases. The development of endovascular technology and the emergence of devices suitable for aortic arch have led to satisfactory short- and medium-term results of the clinical applications of fenestration on a single branch to three branches. The methods of fenestration are mainly mechanical and physical. The former is to use various needles to puncture the fabric, while the latter mainly includes use of thermal energy of laser and radiofrequency to ablate the fabric. This article aims to review the application and progress of in situ fenestration in the treatment of aortic arch diseases.