一体式分支型覆膜支架治疗腹主动脉-髂动脉分叉部病变的疗效分析

Analysis of clinical effect of unibody bifurcated endograft in the treatment of aortoiliac bifurcation lesions

目的探讨一体式分支型支架在腹主动脉-髂动脉分叉部病变中的应用效果。方法回顾性收集2016年8月至2019年1月在首都医科大学附属北京世纪坛医院血管外科接受一体式分支型覆膜支架治疗的18例腹主-髂分叉部病变患者资料,分析其技术成功率和术后疗效。结果 17例患者成功植入一体式分支型覆膜支架系统,技术成功率94.4%。病例均成功使用预置血管缝合器成功封堵穿刺点,无穿刺点出血、假性动脉瘤、闭塞等并发症,平均住院时间(5.0±0.6)d。患者平均随访(13.0±3.0)个月,无支架相关死亡,无动脉瘤及支架移植物破裂,无支架移位。所有患者支架内血流通畅,无髂支闭塞病例,通畅率为100%。术后3个月发现Ⅱ型内漏1例,术后6个月复查时消失,未发现其他类型内漏。结论一体式分支型覆膜支架治疗腹主动脉-髂动脉分叉部病变安全有效,近中期疗效满意,但长期效果还有待进一步研究。

Objective To analyze the clinical effect of unibody bifurcated endograft in the treatment of aortoiliac bifurcation lesions.Methods The clinical data of 18 patients with aortoiliac bifurcation lesions treated by unibody bifurcated endograft in Beijing Shijitan Hospital from August 2016 to January 2019 was collected retrospectively.The technical success rate and postoperative efficacy were analyzed.Results Seventeen patients implanted the unibody bifurcated endograft system successfully,and the technical success rate was 94.4%.The puncture site was successfully blocked with a preset vascular obturator in all cases without complications such as bleeding,pseudoaneurysm and occlusion.The average hospital stay was(5.0±0.6)days.Patients were followed up for an average time of(13.0±3.0)months.There were no stent-related deaths,no aneurysms and stent graft ruptures and no stent displacement.all patients had smooth blood flow in the stent and no iliac branch occlusion.The patency rate was 100%.TypeⅡendoleak was occurred in on case three months after operation,and disappeared three months later.Conclusion The unibody bifurcated endograft is safe and effective in the treatment of aortoiliac bifurcation lesions,and the short-term and mid-term effects are satisfactory,but the long-term effects need to be further studied.