主动脉疾病腔内介入治疗15例体会

Endovascular intervention on 15 patients with aorta disease

目的：总结腔内修复术治疗主动脉疾病的经验、体会，探讨主动脉疾病介入治疗的适应证及操作要点。方法：在气管插管全麻下进行，8例主动脉夹层患者采用直径34—42mm覆膜支架封堵降主动脉近端破裂口，其中1例支架覆盖左锁骨下动脉；6例腹主动脉瘤中1例采用直型支架腔内隔绝，其余均采用分叉型支架经双股动脉置放成功；1例早期主髂动脉硬化性闭塞症患者采用预先扩张主髂动脉狭窄段，置人分又型人工血管支架。结果：全组无手术死亡，腔内隔绝术后造影显示假腔及瘤腔均消失；2例l型内漏，随访半年后消失，假腔内部分血栓形成。1例主动脉夹层患者手术后1年突然死亡。结论：腔内隔绝术治疗主动脉疾病安全、可行、有效，适应证不断扩展。

Objective： To summarize the experience of endovaseular exclusion on aortic diseases, and investigate the intervention therapeutic indications and operational essentials about aortic diseases. Methods ：Tracheal intubation anesthesia was employed in all 15 patients. The endovaseular polyester-covered stent graft exclusion was used to obturate the tear entry on the proximal end of descending aorta in 8 patients with dissecting aneurysm of aorta and the left subclavian artery was obturated in 1 patient. One in 6 abdominal aneuryoms was placed with the straight endovaseular polyester-covered stent graft exclusion while other patients were placed with crotched stent graft through double femoral artery. The pereutaneous transluminal balloon dilatation of crotched stent graft placement was performed in 1 patient with the early aortoilion arterial occlusive disease. Results：There were no death in all treated patients, and pseudocele and cavity of aorta were not found by phlebography after endovaseular exclusion. Type I internal hemorrhage was detected in 2 ptients who were followed up 6 months, and the pseudocele of aorta thrombosis was found partly. One patient died abruptly 1 year later after operation. Condusion ：It is safe, feasible, effective in endovaseular exclusion on aortic diseases, and it could replace traditional operation gradually. Its therapeutic indications could be increased continuously.