3D打印辅助腔内治疗复杂主动脉疾病的临床疗效

Clinical efficacy of 3D printing⁃assisted endovascular treatment of complex aortic disease

目的探讨3D打印辅助腔内治疗复杂主动脉疾病的可行性。方法纳入中山市中医院血管介入科2019年12月至2021年10月收治的5例复杂主动脉疾病患者。术前行CT血管造影(CTA)后进行主动脉三维重建,在3D打印机打印成1∶1主动脉模型,并辅助手术方案制定及进行手术模拟。结果1例肾上型腹主动脉穿透性溃疡,1例近肾型腹主动脉假性动脉瘤,2例累及弓上分支的胸主动脉瘤,1例累及弓上分支的主动脉夹层,所有患者在术前完成主动脉病变段3D模型打印,根据结果辅助制定手术方案,手术技术成功率为100%,无内漏、支架移位或闭塞、内脏动脉丢失等严重并发症出现。结论3D打印辅助腔内治疗能使复杂主动脉疾病腔内治疗直观化、精准化,具有良好的可行性。

Objective To explore the feasibility of 3D printing⁃assisted endovascular treatment of complex aortic disease.Methods Five patients with complex aortic disease admitted to the Department of Vascular Intervention,Zhongshan Hospital of Traditional Chinese Medicine from December 2019 to October 2021 were included.After preoperative CT angiography(CTA),three⁃dimensional reconstruc⁃tion of the aorta was performed,and a 1∶1 aortic model was printed on a 3D printer to assist in surgical strategy formulation and surgical simulation.Results One case of suprarenal abdominal aortic penetrating ulcer,one case of juxtarenal abdominal aortic pseudoaneurysm,two cases of thoracic aortic aneurysm involving the supra⁃arch branches,and one case of aortic dissection involving the supra⁃arc branches.3D model of the aortic lesions was printed before the operation,and the surgical plans were made according to the results.Technical success rate was 100%,there was no endoleak,stent displacement,stent occlu⁃sion or loss of visceral artery branches.Conclusion 3D printing⁃assisted endovascular treatment can make the endovascular treatment of complex aortic diseases intuitive and precise,with good feasibility.