封堵器联合覆膜支架和弹簧圈治疗胸腔内锁骨下动脉瘤

Occluder combined with covered stent-graft and steel coil for the treatment of intra-thoracic subclavain arterial aneurysm

目的探讨用封堵器联合覆膜支架和弹簧圈治疗临近主动脉弓的锁骨下假性动脉瘤的价值。方法经左侧肱动脉通路将室间隔封堵器植于锁骨下动脉起始段,封堵动脉瘤入口;经股动脉通路植入覆膜支架加强封堵效果;再经左侧肱动脉通路以弹簧钢圈封闭假性动脉瘤出口。结果左锁骨下动脉假性动脉瘤入口、开口完全封闭,无内漏,无脑部症状,上肢无明显缺血表现。结论封堵器联合覆膜支架和钢圈的"三介入法"治疗临近主动脉弓的左锁骨下动脉假性动脉瘤,具有微创操作、封闭彻底、机械结构稳定、手术安全性高等优点。

Objective To evaluate the occluder combined with covered stent-graft and coils in treatment of intra-thoracic pseudo-aneurysm at the proximal segment of subclavain artery, Methods The ASD occluder was deployed at the orifice of the subclavain artery via the access of left humeral artery to seal the entrance. The stent-graft was deployed to give additional sealing of the entrance of the left subclavain artery via the access of femoral artery. Finally the coils were deployed at the outlet segment of the oseudo-aneurvsm again via the left humorol artery, to block the reflux. Results The orifice and the outlet of the left subclavain pseudoaneurysm were both sealed thoroughly without endoleak, brain aecident or arm isehemie, symptoms. Conclusions The tri-interventional method utilizing the occluder, covered stent-graft, and the coils in the treatment of the pseudo-aneurysm at the proximal segment of the subclavain artery has the benefits of miniinvasion, thorough sealing, stable frame structure, and assures high security.