支架型人工血管腔内治疗复杂主动脉瘤

Stent-grafts in treating complicated aneurysms

目的：总结15例应用支架治疗复杂动脉瘤的初步经验。方法：Ⅲ型夹层动脉瘤者主动脉极度扭曲1例；破口在弓部的Ⅲ型夹层动脉瘤1例,需先行左右颈-颈和左右腋-腋动脉人工血管搭桥后再封闭左侧颈总动脉和锁骨下动脉；Ⅲ型夹层动脉瘤近侧破口来自于变异发出的右锁骨下动脉1例；Ⅲ型夹层动脉瘤合并肠系膜上动脉几乎完全闭塞和肠缺血1例；Ⅲ型夹层动脉瘤真假腔难判断者4例；腹主动脉瘤瘤颈长度<1 cm需开窗型支架治疗1例；破裂腹主动脉瘤1例；5枚支架治疗胸腹主动脉瘤1例；腹主动脉瘤瘤颈夹角为90°2例；主动脉溃疡紧邻腹腔动脉,需开窗型支架开窗型人工血管治疗1例；肝动脉瘤腹腔动脉瘤合并动静脉瘘1例。结果：15例病人经支架治疗均获得成功。结论：支架型人工血管治疗复杂动脉瘤为微创方法,但需严密设计。

Objective To summarize our experience of grafts stenting technique in treating complicated aneurysms. Methods Fifteen patients with various types of complicated aneurysms were treated by stenting. Of them, 8 were dissecting aortic aneurysms, 4 infrarenal abdominal aortic aneurysms, 1 origenated from the descending aorta extending to the abdominal aorta forming a huge aneurysm, 1 aortic ulcer near the celiac trunk, and 1 celiac trunk aneurysm combined with A-V shunt of the splenic artery. The proximal intimal entries of dissecting aortic aneurysms were sealed. Abdominal aortic aneurysms were excluded using bifurcate stent-grafts. Results Stent-grafts were successfully performed in all cases. Conclusions Stent-grafting is a minimally invasive and safe procedure, and precise designing should be emphasized to obtain satisfactory results.