应用覆膜支架治疗自发性外周动脉夹层9例

目的 探讨应用覆膜支架腔内隔绝自发性外周动脉夹层的安全性及有效性.方法 收集9例自发性外周动脉夹层患者,病变在髂动脉6例,锁骨下动脉3例.术前均行CTA检查,明确外周动脉夹层的部位和程度,预定覆膜支架.所有患者经Seldinger穿刺股动脉后进一步造影明确病变,依据造影结果植入覆膜支架.结果 9例患者中,病变在右侧髂总动脉3例,右侧髂外动脉l例,左侧髂总动脉2例,左侧锁骨下动脉3例.夹层长度0.9～3.3 cm,平均1.7 cm.动脉夹层起始部距靶血管开口距离0.5～5,6 cm,平均2.3 em.所有患者均成功植入覆膜支架,1例覆膜支架覆盖左侧非优势椎动脉,术中无明显并发症发生.随访3～32个月,平均18个月,所有患者均无相关并发症发生,彩色多普勒超声复查示支架通畅.结论 应用覆膜支架腔内隔绝自发性外周动脉夹层是一种安全有效的治疗方法.

The use of covered stent for the treatment of spontaneous peripheral artery dissection: preliminary results in 9 cases

Objective To investigate the safety and effectiveness of using covered stent in endovascular isolation treatment of spontaneous peripheral artery dissection.Methods A total of 9 patients with peripheral artery dissection were collected.The dissectionwas located at iliac artery in 6 patients and at subclavian artery in 3 patients.Preoperative CT angiography was performed in all patients to determine the site and degree of the dissection,based on which the corresponding covered stents were prepared.After puncturing the femoral artery with Seldinger technique,angiography was performed to confirm the lesions in all patients,then,according to the angiographic findings the implantation of covered stent was carried out.Results Among the 9 patients,the dissections were located at the right common iliac artery in 3,at the right external iliac artery in one,at the left common iliac artery in 2 and at the left subclavian artery in 3.The length of the dissection was 0.9-3.3 cm with a mean of 1.7 cm.The distance between the initial part of arterial dissection and the target vessel opening was 0.5-5.6 cm with an average of 2.3 cm.The covered stent was successfully implanted in all patients.In one patient,the implanted stent covered the non-dominant left vertebral artery.During the procedure no obvious complications occurred.The patients were followed up for 3-32 months (mean of 18 months).No procedure-related complications were observed in all patients.Color Doppler ultrasound examination showed that all the implanted stents were unobstructed.Conclusion For peripheral artery dissection,endovascular isolation therapy by using covered stent is safe and effective.