续贯分支导管化技术辅助主动脉腔内修复术重建分支动脉的近期结果

The short-term result of sequential catheterization amid progressive endograft deployment technique for branch artery reconstruction of endovascular aortic repair

目的探讨续贯分支导管化技术(sequential catheterization amid progressive endograft deployment,SCAPED)辅助开窗和分支主动脉腔内修复术重建分支动脉的近期结果。方法回顾性分析天津医科大学总医院2016年11月至2018年12月应用SCAPED辅助开窗和分支主动脉腔内修复术重建分支动脉的13例患者临床资料。结果器械释放成功率100%,无术中死亡病例。无Ⅰa型内漏,Ⅰb型内漏发生率7.7%(1/13),Ⅱ型内漏发生率15.4%(2/13),Ⅲ型内漏发生率15.4%(2/13)。术后30 d死亡率7.7%(1/13)。患者平均随访18.7(6~31)个月),全因死亡率8.3%(1/12),无主动脉相关死亡,二次介入率为16.7%(2/12)。分支动脉均通畅,无截瘫及脑卒中等并发症。结论应用SCAPED可有效提高开窗和分支主动脉腔内修复术的可控性及安全性。

Objective To investigate the short-term result of the sequential catheterization amid progressive endograft deployment(SCAPED)technique for branch artery reconstruction of fenestration/branch endovascular aortic repair.Methods The clinical data of 13 cases treat by fenestration/branch endovascular aortic repair along with SCAPED technique in Tianjin Medical University General Hospital from November 2016 to December 2018 was analyzed retrospectively.Results The success rate of device deployment was 100%.There was no intraoperative death.The incidence rate of typeⅠ,typeⅠb,typeⅡand typeⅢendoleak was 0,7.7%(1/13),15.4%(2/13)and 15.4%(2/13),respectively.The mortality rate at 30 days after operation was 7.7%(1/13).Patients were followed up for an average of 18.7(6~31)months.All-cause mortality was 8.3%(1/12).There was no aortic-related death.The secondary intervention rate was 16.7%(2/12).The branch arteries were unobstructed,and there were no complications such as paraplegia and stroke.Conclusion The safety and maneuverability of fenestration/branch endovascular aortic repair can be improved by the assist of SCAPED technique for thoracoabdominal aortic pathologies.