烟囱技术在StanfordB型主动脉夹层和腹主动脉瘤累及肾动脉修复术的临床应用

CHIMNEY TECHNOLOGY IN STANFORDB TYPE OF ABDOMINAL AORTIC ANEURYSM AND AORTIC DISSECTION INVOLVING THE CLINICAL APPLICATION OF RENAL ARTERY PROSTHESIS

目的探讨烟囱技术在StanfordB型主动脉夹层和腹主动脉瘤累及肾动脉(juxtarenal aortic aneurysms,JAA)修复术的应用的可行性和安全性。方法 2010年01月至2013年01月诊治21例StanfordB型主动脉夹层和腹主动脉瘤累及肾动脉的患者,其中StanfordB型主动脉夹层13例,腹主动脉瘤累及肾动脉8例。所有患者均行先CT增强扫描,后经股动脉穿刺主动脉造影证实,植入覆膜支架行腔内隔绝术并行"烟囱"技术保护重要分支动脉。结果所有患者均成功修复主动脉并保证重要分支动脉如锁骨下动脉和肾动脉通畅。结论 "烟囱"技术的临床应用解决了腔内隔绝术修复主动脉病变的同时避免出现其他被隔绝的重要分支血管的灌注问题,并为解决原发疾病的覆膜支架提供了有效的近端锚定区,甚至可协助消除内漏,从而保证了手术的疗效。

Objective Type chimney technology in StanfordB abdominal aortic aneurysm and aortic dis- section involving the renal artery （juxtarenal aortic aneurysms, JAA） application feasibility and safety of repair. Methods Jan 2010 to jan 2013, 21 cases of diagnosis and treatment of abdominal aortic aneurysm and aortic dissection StanfordB type involving patients with renal artery, which StanfordB type, including 13 cases of aortic dissection, abdominal aortic aneurysm involvement of 8 cases of renal artery. All patients were performed CT enhanced scan, before they are confirmed by femoral artery puncture aortic angiogra- phy, coated stents improperness internal isolation in parallel ＂chimney＂ technology to protect important branch artery. Results All patients were successfully repair the aorta and guarantee important branch such as subclavian artery and renal artery flow. Conclusion The clinical application of ＂ chimney＂ technology solves the lumen of isolated from surgery to repair the aortic lesions at the same time avoid the other im- portant branch of isolated vascular perfusion, and to solve the primary disease of coated stent provides ef- fective proximal anchoring area, even can help eliminate the leakage, to ensure the operation curative effect.