腹主动脉瘤腔内隔绝术术中及术后移植物相关流出道狭窄的认识和处理

Recognition and treatment of outflow tract stenosis during and after endovascular exclusion for abdominal aortic aneurysm

目的 探讨腹主动脉瘤 (AAA)腔内隔绝术 (EVE)术中及术后移植物相关流出道狭窄的认识和处理。方法 回顾性分析我科 1997年 3月至 2 0 0 2年 10月间施行AAAEVE术中 8例出现流出道狭窄 ,术后出现流出道狭窄 3例 ,均为放置分叉型移植物。狭窄多发生于分叉起始端 (5例 )。 7例给予球囊扩张 ,2例置入金属支架 ,2例股股交叉转流术。结果 术后随访 1个月～ 2个年 ,无下肢缺血表现。结论 对于AAAEVE术中及术后移植物相关流出道狭窄 ,要及时诊断 ,判明原因 ,根据原因采取不同的治疗方法。

Objective To study the cognition and treatment of outflow tract stenosis in and after endovascular exclusion for abdominal aortic aneurysm. Methods From Mar 1997 to Oct 2002, in 136 patients undergoing abdominal aortic aneurysm endovascular exclusion, 8 patients had outflow tract stenosis during the operation, and 3 patients had outflow tract stenosis after operation. The stenosis of 5 patients occurred at the crotch of the graft stent. PTA was done in 7 patients with stents placed in stenotic segment in 2 patients. 2 patients were treated with crossover operation. Results Following up 1 month to 2 years, all patients have no lower limbs ischemia. Conclusions The diagnosis of outflow tract stenosis during and after abdominal endovascular exclusion for aortic aneurysm must be in time. The treatment should be according to the different causes of stenosis.