主动脉扩张性疾病腔内修复术中的内脏动脉重建问题

Strategy of visceral arteries reconstruction during the endovascular therapy of the aortic dilated disease

腔内修复术目前已逐渐成为主动脉扩张性疾病的主流治疗方案,但是腔内修复需要在主动脉病变近远端有足够的锚定区.累及内脏动脉和内脏动脉开口附近的病变仍是常规腔内修复术的禁区.近年来,烟囱技术、三明治技术、杂交技术的开展与开窗支架、带分支支架的应用拓展了腔内修复术的应用范围,此类主动脉扩张性疾病患者逐渐获得了腔内修复的机会.不同技术具有各自的特点和适用范围,术者可以根据病变的具体特点、自己的经验和所能获得的腔内修复器材等因素进行判断选择.

Endovascular repair has gradually become the mainstream treatment of aortic dilatation disease.However, endovascular therapy requires sufficient landing zone both in the proximal and distal region of aortic lesion.A large proportion of aortic dilatation lesion was excluded from traditional endovascular therapy due to the visceral artery involvement or being too close to the orifice of viceral artery.Recently, with the adoption of chimney technique, sandwich technique and hybrid technique and the advent of fenestrated and branched stent graft expand the application of endovascular repair technology, rendering these specific type of aortic disease gradually got the chance to endovascular surgery.Different technology has its own characteristics and scope.The surgeons should make their own judgment and selection based on the specific characteristics of lesions, their experience and accessibility to special equipment and other related factors.