3D打印引导下采用开窗或分支支架治疗胸腹主动脉疾病

Treatment of thoraco-abdominal aortic disease with fenestrated stent-graft or branch stent-graft technique guided by 3D printing

目的总结应用3D打印引导下采取预开窗技术和分支支架技术,完全血管腔内治疗胸腹主动脉病变的经验及效果.方法2017年10月至2018年9月,我科收治胸腹主动脉病变患者22例,包括主动脉夹层9例和主动脉瘤13例,平均年龄(60±13)岁男19例,女3例于.术前,根据CT制作3D打印模型导板,然后在3D导板的引导下,在手术中采用了预开窗技术、分支支架技术等完全腔内的方法行腔内修复,共行开窗/分支支架72条结果所有手术均一期完成,无中转开放手术平均手术时间(5.81±1.35)h,术后无肾功能不全和截瘫,1例患者术中损失分支动脉1条(1.4%),1例患者死亡(4.5%).结论应用3D打印技术引导开窗技术治疗累及分支的胸腹主动脉病变较传统测量定位准确,近期效果安全可靠。

Objective To summarize the experience and effect of applying 31) printing to repair thoraco-abdominal aortic disease with fenestrated stent-graft or branch stent-graft technique. Methods From Oct 2017 to Sep 2018,22 patients with thoracic and abdominal aortic diseases, including aortic arterial dissection (9 patients) and aortic aneurysm ( 13 patients) were admitted. There were 19 males and 3 females, with mean agr of (60 ± 13 ) years. Before lhe surgery 3D printing model guide plale was made according to CT, and then the pre-fenestrated stent-graft technique, branch stent-giaft technique and other techniques were adopted in the surgery to prrfonn endovascular repair. Results All of the operations were completed in one stage without open surgery. The average operation time was ( 5. 67 ± 1.23 ) hours without renal insufficiency and paraplegia, 1 branch artery was lost during operation ( 1.4%) and 1 patient died (4. 5%). Conclusion The application of 3D printing in the treatment of thoraco-abdominal aortic disease involving branches is more accurate than traditional measurement and localization. It had a safe and reliable short-term result.