对吻式支架技术和主髂动脉分叉部覆膜支架重建技术在主髂动脉闭塞症中的使用策略

Strategies for the use of kissing stents and covered endovascular reconstruction of aortic bifurcation in aortoiliac occlusive disease

主髂动脉闭塞的主要病理变化为动脉粥样硬化导致的腹主动脉远端以及主髂动脉分叉处血管狭窄或闭塞,继而引发盆腔和下肢缺血。伴随血管腔内技术的迅速发展,腔内治疗已逐渐成为治疗此类疾病的主要手段。其中,对吻式支架技术和主髂动脉分叉部覆膜支架重建(CERAB)技术是两项应用于复杂主髂动脉闭塞的技术探索,大大地改变了对于主髂动脉闭塞症的治疗理念。本文结合体外几何流体力学基础研究以及国际临床研究现状,旨在探讨对吻支架技术和CERAB技术治疗主髂动脉闭塞疾病的技术特点、技术优势以及临床经验。

The main pathological changes of aortoiliac occlusive disease are the stenosis or occlusion of the distal abdominal aorta and aortoiliac bifurcation caused by atherosclerosis,which potentially leads to symptoms such as pelvic ischemia and lower limb ischemia.Progress is being made in endovascular treatment,which has gradually become the main means to treat the disease.Kissing-stent technique and covered endovascular reconstruction of aortic bifurcation(CERAB)technique were established as significant procedures for complex aortoiliac occlusive diseases.Based on the studies of in vitro geometry,hemodynamics,and clinical applications,this article aims to discuss the technical characteristics,technical advantages,and clinical experiences of kissing-stent and CERAB techniques in the treatment of aortoiliac occlusive disease.