新型低渗透性覆膜支架治疗腹主动脉瘤24例报道

New low-permeability excluder aortic covered stent graft for the treatment of 24 patients with abdominal aortic aneurysm

目的：应用新型低渗透性设计EXCLUDER覆膜支架治疗腹主动脉瘤，评价其安全性和疗效。方法2011年4月至2013年10月，24例腹主动脉瘤患者应用新型低渗透性设计的EXCLUDER覆膜支架行腔内修复术。结果24例手术均获成功，无中转开腹及术中死亡病例，2例术后住院期间死于慢性心功能不全合并多器官功能衰竭，1例术后脑梗塞。手术时间为(130.23±12.45) min，术中出血量为(180.23±20.76)ml，均无输血。术中Ⅰ型微内漏2例，Ⅱ型内漏2例，Ⅲ型内漏1例，均术中处理满意。术后随访22例，随访时间3~32个月，21例存活，1例术后22个月死于糖尿病并发症。随访患者复查CTA显示支架贴壁满意，无移位，无与支架相关的并发症发生。结论采用新型低渗透性设计的EXCLUDER覆膜支架治疗腹主动脉瘤，明显降低了手术风险，适合于大多数腹主动脉瘤患者的治疗，近期效果满意，其中、远期效果尚需大宗病例进一步观察。

Objective To evaluate the surgical safety and effect of the new low-permeability Excluder aortic covered stent graft for the patients with abdominal aortic aneurysm(AAA). Methods 24 patients with AAA underwent operation with placement of the new low-permeability Excluder aortic covered stent graft from April 2011 to October 2013. Results 24 patients were successfully performed, of which 2 died of multiple organ failure and 1 suffered from cerebral infarction after operation in hospital. The mean operation time was (130.23±12.45) minutes, intraoperative bleeding was(180.23±20.76)ml,all patients have no blood transfusion. The DSA showed that 2 patients are mildⅠtype endoleak,2 patients areⅡtype endoleak and 1 patient isⅢtype endoleak.All patients had satisfactory result.D Of 22 patients with AAA underwent operation, 21 survival and 1 diabetic complication after operation during the period of following-up of 3 to 32 months.The examination results on computed tomography angiography(CTA)for the postoperative patients showed that there were no complications with stent graft. Conclusions The placement of the new low-permeability Excluder aortic covered stent graft for the treatment of the patients with AAA could obviously decrease the operative risk. The most patients with AAA were ift for this kind of operative modality, This kind of operative modality had a good short-term effect and its middle and long-term results were waited to be advanced observed.