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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): 617-622    DOI: 10.3785/j.issn.1008-9292.2018.12.09
专题报道     
胸主动脉覆膜支架原位开窗技术的应用现状
向一郎(),吴子衡,张鸿坤*()
浙江大学医学院附属第一医院血管外科, 浙江 杭州 310003
Progress on in situ fenestration during thoracic endovascular aortic repair
XIANG Yilang(),WU Ziheng,ZHANG Hongkun*()
Department of Vascular Surgery, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China
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摘要：

主动脉弓部病变血管内治疗因病变部位解剖复杂、毗邻重要分支而颇具挑战性。主动脉支架原位开窗技术作为处理此类复杂部位病变的一种超适应证方法，充分利用目前可获得的器械，在保留弓上分支血管的前提下，尽可能发挥胸主动脉血管内修复术的微创优势。原位开窗技术的特点是释放主体支架后，通过在支架壁上运用不同方法破膜，形成与分支血管对合的窗口，再通过窗口植入分支支架，维持隔绝区域分支血管的血流。该技术目前临床应用越来越广泛。本文就原位开窗技术的操作步骤以及临床应用进展作一综述。
关键词： 动脉瘤, 夹层/外科学;  血管假体植入;  支架;  主动脉, 胸/外科学;  激光;  综述    
Abstract:

Endovascular aortic arch repair remains challenging due to the complicated anatomy and the involved vital branches. Off-label techniques emerged during the last decade, including endografts with parallel stents (known as Chimney, Periscope, Sandwich), surgeon-modified endografts, and various other reported techniques. In situ fenestration of standard endografts represents another off-label endovascular means to maintain perfusion to aortic side branches located in the excluded area. Its principle is based on fenestration of an endograft following its deployment inside the vascular system. As data are emerging regarding in situ fenestration, the aim of this article is to review recent progress of technical descriptions, in vitro and clinic results of in situ fenestration from the available literature.
Key words: Aneurysm, dissecting/surgery    Blood vessel prosthesis implantation    Stents    Aorta, thoracic/surgery    Lasers    Review
收稿日期: 2018-08-14 出版日期: 2019-03-15
:  R654  
基金资助: 国家自然科学基金(81700420);浙江省自然科学基金(LY16H020004)
通讯作者: 张鸿坤     E-mail: xyl9208@126.com;1198050@zju.edu.cn
作者简介: 向一郎(1992-), 男, 硕士研究生, 主要从事主动脉及外周血管疾病研究; E-mail:xyl9208@126.com; https://orcid.org/0000-0002-0536-6576
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引用本文:

向一郎,吴子衡,张鸿坤. 胸主动脉覆膜支架原位开窗技术的应用现状[J]. 浙江大学学报（医学版）, 2018, 47(6): 617-622.

XIANG Yilang,WU Ziheng,ZHANG Hongkun. Progress on in situ fenestration during thoracic endovascular aortic repair. J Zhejiang Univ (Med Sci), 2018, 47(6): 617-622.

链接本文:

http://www.zjujournals.com/med/CN/10.3785/j.issn.1008-9292.2018.12.09    或    http://www.zjujournals.com/med/CN/Y2018/V47/I6/617

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