3D打印辅助体外预开窗技术治疗复杂胸/腹主动脉瘤的临床经验

The clinical experience and effect of applying 3D printing assisted with the technology of extracorporeal pre-fenestration in the treatment of thoracic/abdominal aortic aneurysm

目的:总结3D打印辅助体外预开窗技术治疗胸/腹主动脉瘤的临床经验。方法:2019年8月至2020年11月,我中心收治15例累及内脏动脉的胸/腹主动脉瘤患者,男11例,女4例,年龄57~82(68.26±4.73)岁。根据患者术前CTA测量内脏区动脉、胸主动脉、腹主动脉、双侧髂动脉的直径,选取合适支架,并通过专业软件制作3D打印模型,指导术中体外预开窗位置及开窗直径,实施全腔内修复。结果:所有手术均一期完成,1例患者中转开腹,手术(200.67±41.00)min,住院(13.47±4.16)天,无死亡、脏器功能衰竭、内漏、截瘫、置入物感染等并发症。结论:应用3D打印辅助体外预开窗技术治疗累及内脏动脉的复杂胸/腹主动脉瘤方案可行有效,近期效果满意。

Objective To summarize the clinical experience and effect of applying 3D printing assisted with the technology of extracorporeal pre-fenestration in the treatment of thoracic/abdominal aortic aneurysm.Methods From August 2019 to November 2020,15 patients with thoracic/abdominal aneurysm involving visceral arteries were admitted to our center,including 11 males and 4 females,with mean age of 57-82(68.26±4.73)years old.According to diameters of visceral artery,thoracic aorta,abdominal aorta,and bilateral iliac arteries measured by CTA,we selected suitable stents and made a 3D printing model by professional software to guide the position of intraoperative external fenestration and the fenestration diameter to implement full cavity repair.Results All operations were completed and one case was converted to laparotomy.The average time of operations was(200.67±41.00)min and hospital stay was(13.47±4.16)days without any death,organ failure,endoleak,paraplegia,graft infection and other complications.Conclusion The application of 3D printing assisted with the technology of extracorporeal pre-fenestration in the treatment of thoracic/abdominal aortic aneurysm is feasible and effective,and the short-term results are satisfactory.