经颈动脉腔内技术重建主动脉弓治疗Stanford A型夹层动脉瘤(附1例报告)

目的探讨血管腔内技术重建主动脉弓治疗升主动脉、主动脉弓病变的可行性。方法2005年,对1例StanfordA型夹层动脉瘤,腔内修复主动脉病变之前做右颈总动脉-左颈总动脉-左锁骨下动脉的旁路术;经右颈总动脉将修改的分叉支架型血管主体放入升主动脉,长臂位于无名动脉。短臂应用延长支架型血管延伸至降主动脉。通过腔内技术重建主动脉弓实现累及升主动脉和主动脉弓主动脉病变的微创治疗。结果腔内修复术后移植物形态良好,血流通畅,病变被隔绝,脑、躯干、四肢循环稳定。无严重并发症。结论该手术方案设计合理、技术可行。可能成为复杂胸主动脉病变新的腔内治疗模式。

Transcarotid artery endovascular reconstruction of aortic arch by modular bifurcated stent graft for Stanford A dissection:a report of 1 case

Objective To study the possibility of ascending aorta or aortic arch lesion treated by endovascular reconstruction of aortic arch.Methods In 2005,one case of Stanford A dissection was performed transcarotid artery endovascular reconstruction of aortic arch by modular bifurcated stent graft.The right common carotid artery-left common carotid artery-left subclavian artery bypass was done before endovascular repair.A modular bifurcated stent-graft was deployed from right common carotid artery in ascending thoracic aorta with long limb in innominate artery and short limb in aortic arch and descending thoracic aorta deployment.The ascending thoracic aorta and aortic arch were reconstructed completely by bifurcated stent graft.Results Wonderful stent graft configuration,nice blood flow,and stable hemodynamics were occurred after operation.No crucial complication was occurred.Conclusions It's possible to reconstruct aortic arch by bifurcated stent graft.It will be a new endovascular repair model for complex thoracic aortic aneurysm and dissection.