腔内治疗腹主动脉瘤髂内动脉重建方法及其评价

Reconstruction method and evaluation of internal iliac artery in endovascular treatment of abdominal aortic aneurysm

腹主动脉瘤的腔内治疗已成为其治疗的主流方法,有相当部分的腹主动脉瘤涉及到髂内动脉的处理,而重建髂内动脉的必要性也逐渐得到了学界的认可。髂内动脉的解剖决定了其重要临床意义,早期多应用杂交手术重建方案,后逐渐出现了基于非专用器材的Sandwich技术、Crossover烟囱技术、Trifurcated endograft技术、Bell-bottom技术等腔内治疗方案以及近期出现的专用的髂动脉分叉装置等。各种方法都有其特点和适用条件,血管外科医生应熟知和掌握各种方法,为病人制定最优治疗方案。

Endovascular aneurysm repair (EVAR)has been the major treatment for abdominal aortic aneurysm (AAA).A significant proportion of patients with AAA has an ectatic or aneurysmal common iliac artery,which raises the concern about how to treat the internal iliac artery (IIA).The anatomy of IIA is important for the preservation of IIA.After hybrid technique in the early stage,Sandwich technique,Crossover chimney technique,Trifurcated endograft technique, Bell-bottom technique,as well as newly developed iliac branched device were developed.Various methods should be well known and mastered to formulate the optimal treatment plan for patients.