Amplatzer血管塞联合Interlock可解脱弹簧圈栓塞治疗B型主动脉夹层TEVAR联合颈动脉烟囱支架治疗术后高流量Ia型内漏

Embolization with Amplatzer vascular plugs and Interlocks for the treatment of high flow type Ia endoleak post-Chimney TEVAR

目的探讨使用Amplatzer血管塞联合Interlock可解脱弹簧圈对B型主动脉夹层腔内修复术后的Ia型内漏栓塞治疗的有效性。方法采用Amplatzer血管塞联合Interlock对5例B型主动脉夹层腔内修复术后出现的Ia型内漏进行栓塞治疗。观察手术的成功率和并发症,并通过CT随访观察临床疗效。结果平均每个病人使用的Amplatzer血管塞和Interlocks的数量分别为3.4和2.6个。5例患者均栓塞成功,无手术并发症及住院死亡患者。术后平均随访时间为13.8个月(3～24个月)。随访期间,Ia型内漏均完全栓塞。结论 Amplatzer血管塞联合Interlock栓塞治疗B型主动脉夹层腔内修复术后Ia型内漏的成功率高、并发症少,是安全有效的方法之一。

Objective To evaluate the efficacy and clinical outcomes of embolization with Amplatzer vascular plug and Interlock in the treatment of high flow type Ia endoleak after chimney TEVAR of type B aortic dissection. Methods All patients with type Ia endoleaks formed after chimney TEVAR were embolized with Amplatzer vascular plugs and Interlocks. The embolization target was the perigraft space and the primary intimal tear. The success and complication rates were recorded. Patients were followed up by contrast-enhanced computed tomography 1,3,and 6 months postoperatively and every 12 months there after. Results This prospective study included 5 patients. The mean number of Amplatzer vascular plugs and Interlocks used for embolization was 3.4 and 2.6 respectively. The mean clinical follow-up duration was 13.8 months( 3 ~ 24 months). During the follow-up, all the type Ia endoleaks were totally embolized,and the aortic remodeling became better. Conclusions Embolization with Amplatzer vascular plug and Interlock to treat high flow type Ia endoleak after chimney TEVAR is effective and safe.