主动脉弓部病变的腔内治疗进展
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郭伟, Email: pla301dml@vip.sina.com

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首都卫生发展科研专项基金资助项目(首发2020-2Z-5014);国家重点研发计划基金资助项目(2020YFC1107700)。


Progress in endovascular treatment of aortic arch diseases
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    摘要:

    主动脉弓部病变主要包括动脉瘤和夹层。传统开放手术需要开胸及体外循环,创伤大、并发症发生率高,因此高龄及高外科风险患者常常无法耐受手术。腔内技术以其微创、有效的优势,已成为左锁骨下动脉以远胸降主动脉病变的首选治疗方法。但由于弓部病变具有邻近心脏、重要分支血管多、血流速度快等特点,腔内治疗仍面临着巨大的挑战。目前应用于主动脉弓的腔内治疗技术很多是超适应证范围的,远期疗效尚不明确。分支支架技术因其更符合人体的正常解剖结构及血流状态,术中通常不需要进行脑保护措施,因此是国内外学者研究的热点方向。

    Abstract:

    Aortic arch lesions mainly include aneurysm and dissection. Traditional open surgery requires thoracotomy and cardiopulmonary bypass, which is huge traumatic and has a high incidence of complications. Therefore, elderly patients or those with high surgical risks often cannot tolerate the operation. With its minimally invasive and effective advantages, the endovascular technique has become the first choice for the treatment of the descending thoracic aorta aneurysm or type B dissection. However, due to the characteristics of arch lesions near the heart, many important branch vessels, and fast blood flow, endovascular treatment still faces many challenges. At present, some endovascular treatment techniques applied to the aortic arch are off-label use and the long-term efficacy is not clear. The branched endovascular arch repair technique is more in line with the normal anatomical structure and blood flow state of the human body. It usually does not require brain protection measures. Therefore, it is a hot research direction of scholars at home and abroad.

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张宏鹏, 郭伟.主动脉弓部病变的腔内治疗进展[J].中国普通外科杂志,2020,29(12):1415-1419.
DOI:10.7659/j. issn.1005-6947.2020.12.001

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  • 收稿日期:2020-11-20
  • 最后修改日期:2020-12-05
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  • 在线发布日期: 2020-12-25