无名动脉及左颈总动脉起始部狭窄及闭塞的治疗体会

Treatment for innominate artery and left common carotid artery stenosis and occlusion

目的：探讨无名动脉及左颈总动脉起始部狭窄及闭塞的治疗方法。方法：对2006年12月至2015年9月,收治的15例无名动脉及左颈总动脉起始部狭窄及闭塞患者的临床资料进行回顾性分析。15例患者中,完全腔内技术治疗4例,杂交技术5例,工血管旁路移置术6例,对围手术期和随访结果进行分析。结果：所有病例均顺利完成手术。全组无脑血管并发症发生。围手术期并发症包括主动脉夹层1例、泌尿系感染1例,上呼吸道感染1例,均经保守治疗好转出院,无患者死亡。15例患者均进行了随访,随访时间7-112个月,完全腔内治疗组有1例患者于术后25个月发现无名动脉支架内再狭窄,其余患者无再狭窄及其他并发症发生。结论：无名动脉及左颈总动脉起始部的狭窄及闭塞可以根据具体情况采用腔内技术、杂交技术以及开放手术治疗,围手术期及远期效果满意,是安全、有效的治疗方法。

Objective： to investigate the treatment for innominate artery and left common carotid artery stenosis and occlusion. Methods： Between December 2006 and September 2015, 15 patients with innominate artery and left common carotid artery stenosis and occlusion were treated. Four of them were treated with endovascular technique, 5 patients were treated with hybrid technique, and 6 patients underwent open surgery. The perioperative and follow-up outcomes were analyzed. Results： All procedures were completed successfully, no cerebrovaseular complications occured. Perioperative complications included aorta dissection in one patient, uri- nary infection in one patient and upper respiratory tract infection in one patient, which were improved with medi- cine treatment, no patient died. Follow-up time ranged from 7 to 112months. In stent stenosis was observed in one patient of endovascular group at 25 months after the operation, on other restenosis and complications oc- cured. Conclusion： Innominate artery and left common carotid artery stenosis and occlusion can be treated with endovascular technique,hybrid technique and open surgery according to each patient＇ s characteristic, and all these treatments are effective and safe.