自膨式小覆膜支架在动脉疾病治疗中的应用

Application of small covered self-expanding stent in arterial disease

目的:探讨自膨式小覆膜支架在动脉疾病治疗中的应用价值。方法:回顾性分析2007年10月—2011年5月应用自膨式小覆膜支架治疗动脉相关疾病30例的临床资料。结果:在全组患者中,髂总动脉出血2例,颈动脉出血2例,左锁骨下动脉出血1例,下肢外伤性动静脉瘘2例,先天性动静脉瘘3例,锁骨下动脉瘤2例,急性主动脉疾病5例,慢性主动脉夹层远端破口4例,主髂动脉闭塞性疾病9例。所有患者支架均成功植入,原发疾病得到有效治疗。随访3～36个月,平均16个月。2例颈动脉出血者术后12个月复查时发现支架闭塞,但无神经系统症状,其余病例复查多普勒超声和增强CT提示支架内血流通畅。结论:自膨式小覆膜支架在动脉疾病治疗中,具有快速、微创、疗效确切等优点,在某些特殊情况下,它起到了不可替代的作用。

Objective： To investigate the application value of small covered self-expanding stentt in treatment of arterial disease. Methods： The clinical data of 30 patients undergoing implantation of small covered self-expanding stent for artery related disease from October 2007 to May 2011 were retrospectively analyzed. Results： Of the patients, there were 5 cases of arterial bleeding, whose lesions were located on common iliac artery （2 cases）, carotid artery （2 cases） and left subclavian artery （1 case） respectively, 2 cases of traumatic arteriovenous fistula of the lower limb, 3 cases of congenital arteriovenous fistula, 2 cases of subclavian artery aneurysm, 5 cases of acute aortic syndrome, 4 cases of chronic aortic dissection with a second tear and 9 cases of aortoiliac occlusive disease. Stents were successfully implanted in all patients and the primary lesions of the patients were substantially resolved. The follow-up period ranged from 3 to 36 months, with an average of 16 months. In the 2 patiants with carotid artery hemorrhage, stent occlusion occurred 12 months after operation, but no nervous system problems were noted. The stents in the remaining patients were all patent as shown by Doppler ultrasound and contrast-enhanced CT examination.Conclnsion： Small covered self-expanding stent implantation for arterial disease is a fast performed operation,with minimal invasion and demonstrable efficacy3 and is irreplaceable in some special cases.