下行双导丝技术在复杂腹主动脉瘤腔内治疗中的应用

Application of descending double guide wire in endovascular treatment of complicated abdominal aortic aneurysm

目的探讨下行双导丝技术在复杂腹主动脉瘤腔内隔绝术(EVAR)中操作要点和应用价值。方法回顾2007年7月至2011年10月14例复杂腹主动脉患者采用下行双导丝技术经双侧股动脉植入覆膜支架,对腹主动脉瘤进行腔内支架治疗。结果 14例手术获成功,手术时间为2～3 h,其中1例术后出现单侧下肢缺血;随访3～24月,14例均生存良好,未发生支架移位、严重内漏及肾功能衰竭等严重并发症。结论下行双导丝技术在腔内支架治疗复杂解剖形态腹主动脉瘤中,具有操作时间短、操作容易、安全性高等优点,值得推广。

Objective To investigate the technique and value of descending double guide wire in endovascular treatment of complicated abdominal aortic aneurysm. Methods From July 2007 to October 2011, 14 patients with complicated abdominal aortic aneurysm were treated with endovascular repair. Descending double guide wire technique was used for the procedure on all patients. Results The procedure was successful on all patients with the procedure time of 2-3 h. One patient had complication of lower extremity ischemia after the procedure. All patients survived without stent displacement, endoleak or renal failure in the 3-24 month follow-up period. Conclusion Descending double guide wire is a faster and safer method for the endovascular treatment of complicated abdominal aortic aneurysm.