做好胸腹主动脉瘤的全微创治疗

Minimally invasive treatment of thoracoabdominal aortic aneurysm

胸腹主动脉瘤(TAAA)是一种复杂的主动脉疾病, 大多数患者无症状, 但治疗不及时死亡率较高, 其治疗方面仍存在较大挑战。TAAA的血管腔内修复以开窗/分支支架技术临床应用得较多, 是目前腔内治疗发展的热点, 手术的难点在于内脏动脉的超选和分支支架的植入。提高手术的远期效果, 需把握各类手术的适应证, 术前精确规划, 术中对主体支架束径, 预防主体支架植入后的位移及内漏, 同时要考虑术后动脉瘤的形变和分支支架的稳定性。

Thoracoabdominal aortic aneurysm is a complex aortic disease.Most of the patients have no symptoms,but the untimely treatment is related to higher mortality.Besides,there is a big challenge in the treatment.Endovascular repair with fenestrated/branched stent grafts is widely applied and has become a popular topic for the development of endovascular treatment.The difficulty of the operation is the superselection of visceral arteries and branched stent implantation.To improve the long-term effect of the operation,it is necessary to understand the indications of various operations,make an accurate plan before the operation,reduce the diameter of the main stent during the operation,prevent the displacement of the main stent and the endoleak after the operation,and consider the deformation of the aneurysm and the stability of the branched stent after the operation.