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浙江大学学报（医学版）
浙江大学学报（医学版）  2018, Vol. 47 Issue (6): 612-616    DOI: 10.3785/j.issn.1008-9292.2018.12.08
专题报道     
一体式覆膜支架治疗分叉部狭窄腹主动脉瘤患者疗效分析
卢凯平(),卢惟钦,杨光唯,来集富,吴昊,蒋劲松*()
浙江省人民医院血管外科, 浙江 杭州 310014
Endovascular treatment of abdominal aortic aneurysm and aortic bifurcation stenosis by unibody bifurcation stent graft
LU Kaiping(),LU Weiqing,YANG Guangwei,LAI Jifu,WU Hao,JIANG Jinsong*()
Department of Vascular Surgery, Zhejiang Provincial People's Hospital, Hangzhou 310014, China
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摘要：

目的: 总结一体式覆膜支架在分叉部狭窄腹主动脉瘤中的临床使用特点及效果。方法: 回顾性分析2009年3月至2018年3月浙江省人民医院血管外科采用一体式覆膜支架治疗的19例腹主动脉瘤伴分叉部狭窄患者的资料、手术方法和随访结果。结果: 所有患者均支架植入成功，平均手术时间为（70.0±2.3）min，3例患者出现术中内漏（其中Ⅰ型内漏2例，Ⅱ型内漏1例），术后15 d复查消失。19例患者随访9~48个月，中位随访时间为27个月，无支架移位、远期内漏、下肢缺血。结论: 一体式支架的结构设计更适合腹主动脉瘤伴主动脉分叉部狭窄的患者，且可避免术后支架远端移位，中远期疗效较好。
关键词： 主动脉瘤, 腹/外科学;  支架;  外科手术, 微创性;  回顾性研究    
Abstract:

Objective: To sum up experience in unibody bifurcation stent graft in the treatment of abdominal aortic aneurysm with aortic bifurcation stenosis. Methods: Clinical data of 19 cases of abdominal aortic aneurysm and aortic bifurcation stenosis received endovascular treatment using unibody bifurcation stent graft in Zhejiang Provincial People's Hospital during March 2009 and March 2018 were collected. The clinical characteristics, surgery procedure and follow-up results were reviewed. Results: Stent graft was successful in all patients, and the average operation time was (70.0±2.3) min. Leakage was found in 3 patients, in which 2 patients with type Ⅰ leakage and 1 patient with type Ⅱ leakage. All leakage disappeared 15 days after surgery. The 19 cases were followed-up for 9-48 months with the median follow-up time of 27 months, and no displacement, leakage and lower limb ischemia was observed. Conclusion: Unibody bifurcation stent graft is of satisfactory long-term effect for patients with abdominal aortic aneurysm and aortic bifurcation stenosis, and can avoid displacement of stent graft after operation.
Key words: Aortic aneurysm, abdominal/surgery    Stents    Surgical procedures, minimally invasive    Retrospective studies
收稿日期: 2018-08-14 出版日期: 2019-03-15
:  R654  
通讯作者: 蒋劲松     E-mail: lkaiping@163.com;654614713@qq.com
作者简介: 卢凯平(1984-), 男, 硕士, 主治医师, 从事血管外科临床工作; E-mail:lkaiping@163.com; https://orcid.org/0000-0003-1882-9127
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卢凯平
卢惟钦
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来集富
吴昊
蒋劲松

引用本文:

卢凯平,卢惟钦,杨光唯,来集富,吴昊,蒋劲松. 一体式覆膜支架治疗分叉部狭窄腹主动脉瘤患者疗效分析[J]. 浙江大学学报（医学版）, 2018, 47(6): 612-616.

LU Kaiping,LU Weiqing,YANG Guangwei,LAI Jifu,WU Hao,JIANG Jinsong. Endovascular treatment of abdominal aortic aneurysm and aortic bifurcation stenosis by unibody bifurcation stent graft. J Zhejiang Univ (Med Sci), 2018, 47(6): 612-616.

链接本文:

http://www.zjujournals.com/med/CN/10.3785/j.issn.1008-9292.2018.12.08    或    http://www.zjujournals.com/med/CN/Y2018/V47/I6/612

图 1  一例患者腹主动脉CT血管造影断层图像
图 2  支架植入前后CT血管造影和数字减影血管造影图像
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