腹主动脉瘤腔内治疗84例分析

Endovascular repair of abdominal aortic aneurysms:an analysis of 84 cases

目的总结腹主动脉瘤腔内治疗经验。方法2001年9月至2008年12月北京协和医院血管外科采用血管腔内修复治疗腹主动脉瘤84例。结果84例腹主动脉瘤腔内修复均获成功(包括8例动脉瘤破裂急诊腔内修复术)。应用分叉支架77例,直型支架7例,其中包括开窗支架2例。术后30d内死亡2例(病死率为2.4%),分别死于急性心肌梗死和感染性休克。结论腹主动脉瘤腔内修复是安全有效的方法,其治疗成功的关键主要在于了解动脉瘤的解剖形态,掌握适应证、操作技术、并发症的处理以及伴随疾病的治疗是关键。

Objective To summarize experiences of endovascular treatment on 84 patients with abdominal aortic aneurysms. Methods From September 2001 to December 2008, 84 cases of abdominal aortic aneurysm were treated with endovascular repair in Peking Union Medical College Hospital. Results Eighty-four cases of abdominal aortic aneurysm were performed endovascular repair successfully（include 8 emergency procedures）. Seventy-seven bifurcated stent grafts and 7 tubular stent grafts, including two fenestrated stent grafts, were deployed. Two cases died within 30 days after the procedures. Among them, one died of acute myocardial infarction and another died of septic shock. Conclusion Endovascular repair of abdominal aortic aneurysm is safe and feasible. The indications of endovascular repair of aortic aneurysms, skills of interventional procedure, management of complications and treatment of concomitant disease are the key factors of successful operation.