TEVER 术中主动脉弓部分支动脉的重建
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蒋京军, Email: jjjdoctor@163.com

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Reconstruction of supra-aortic branches during thoracic endovascular aortic repair
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    摘要:

    目的:探讨胸主动脉腔内修复术中主动脉弓部分支动脉的重建方法。 方法:回顾性分析北京大学人民医院2001年12月—2014年3月间45例行胸主动脉腔内修复术患者的临床资料。 结果:分别通过杂交技术、烟囱技术、分支支架技术共重建分支动脉64支,其中包括无名动脉6支,右颈总动脉1支,左颈总动脉21支,左锁骨下动脉36支。技术成功率100%,术后7例患者发生内漏,30 d内死亡4例。39例患者获随访2~89个月,期间1例于手术后45 d可疑死于脑梗塞,2例死于与胸主动脉疾病无关的原因;1例患者内漏仍存在,所有桥血管、烟囱支架等保持通畅。 结论:通过杂交手术、烟囱技术及分支支架技术重建弓部分支动脉后行TEVER手术是安全可行的,其短期效果令人满意,其远期效果仍有待继续观察。

    Abstract:

    Objective: To investigate the methods for reconstruction of the supra-aortic branches during thoracic endovascular aortic repair (TEVER). Methods: The clinical data of 45 patients undergoing TEVER in Peking University People’s Hospital from December 2001 to March 2014 were retrospectively analyzed. Results: A total of 64 supra-aortic branches that included 6 innominate arteries, 1 right common carotid artery, 21 left common carotid arteries, and 36 subclavian arteries, were reconstructed by hybrid technique, chimney technique and branched endografts respectively. The technical success rate was 100%, and endoleak was found in 7 cases and 4 cases died within 30 days after operation. Follow-up was obtained in 39 patients for 2 to 89 months, during which time, one case died of suspicious cerebral infraction and 2 cases died of causes not related to thoracic aortic disease; one endoleak persisted and all the bypass and chimney stents were patent. Conclusion: TEVER following supra-aortic branch reconstruction by hybrid surgery, chimney technique and branched endograft is safe and feasible. Although its short-term effect is satisfactory, its long term effect requires further observation.

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孙占国,蒋京军,张小明,张学民,李伟,李清乐,何长顺. TEVER 术中主动脉弓部分支动脉的重建[J].中国普通外科杂志,2014,23(12):1609-1613.
DOI:10.7659/j. issn.1005-6947.2014.12.002

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  • 收稿日期:2014-10-10
  • 最后修改日期:2014-11-20
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  • 在线发布日期: 2014-12-15