一體式分叉型覆膜支架在介入治療孤立性髂動脈瘤中的應用
【摘要】目的 探討一體式分叉型覆膜支架應用于介入治療孤立性髂動脈瘤(IIAAs)的安全及有效性。方法 回顧性分析本中心自2011年8月至2016年7月,共7例男性患者,年齡49~22歲,平均年齡(69±10.5)歲,因IIAAs接受一體式分叉型覆膜支架介入治療。其中單側病變3例;雙側病變4例,4 例合并髂內動脈瘤。6例患者使用Microport Aegis-B—體式分叉型覆膜支架,1例使用Powerlink一體式分叉型覆膜支架,遠端共使用9枚髂動脈延長支架。1例患者行髂內動脈預栓塞以避免II型內漏。術后分別于1、6、12個月及以后每年一次行臨床及影像隨訪。結果:7例患者均成功置入一體式覆膜支架,技術成功率為100%。一體式支架主體近端直徑為24~26 mm,長度為80~92 mm。6例患者單側髂內動脈開口覆蓋,1例患者雙側髂內動脈開口覆蓋,無盆腔及臀肌缺血發生,圍術期無嚴重并發癥發生。平均隨訪時間(32.55±19)個月(12~70個月)。患者隨訪期內無支架移位,無支架相關死亡等嚴重并發癥。1例隨訪內發現輕度II型內漏。結論 一體式分叉型覆膜支架治療IIAAs安全有效,近中期療效滿意,特別是對于近端錨定區不足或雙側受累的患者有其獨到特殊的應用優勢。
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一體式分叉型覆膜支架在腹主動脈及髂動脈病變腔內治療中的應用
【摘要】目的 探討一體式分叉型覆膜支架治療腹主動脈及骼動脈病變的療效。方法 本組31例患者應用一體式分叉型覆膜支架治療,男26例,女5例;年齡38~84歲,平均(64.5±10.7)歲。腹主動脈真性動脈瘤17例,腹主動脈穿通潰瘍5例,髂動脈瘤4例(雙側受累2例),腹主動脈假性動脈瘤2例,腹主動脈瘤EVAR術后遠端漏2例,腹主動脈夾層1例。使用Microport Aegis(上海微創)支架22例,Powerlink(ENDOLOGIX公司)支架9例。術后1、3、6、12個月及以后每年一次行檢查隨訪。結果 31例均成功置入支架,手術成功率100%。覆膜支架主體近端直徑20~28 mm,主體支架長度120~240 mm;封閉一側髂內動脈13例,雙側動內動脈均保留15例。隨訪3~36個月,支架內血流通暢,無內漏及支架移位發生。結論 一體式分叉型覆膜支架治療腎下腹主動脈病變及動動脈病變近中期療效滿意,遠期療效尚需長期隨訪。
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Contemporary Results of Endovascular Repair of Isolated Abdominal Aortic Dissection with Unibody Bifurcated Stent Grafts
【摘要】Objectives: To report the midterm safety and efficacy of the Aegis-B (Microport, Shanghai, China) unibody bifurcated stent graft for endovascular treatment of isolated abdominal aortic dissection (IAAD). Background: Isolated abdominal aorta dissection (IAAD) is a rare event. Endovascular stent grafts seem to offer an efficient therapeutic approach to treat IAAD. However, the relatively small diameter of the infrarenal aorta and aortic bifurcation remains the main anatomical limitation to endovascular repair. Methods: Between 2008 and 2015, we retrospectively evaluated 32 IAAD patients (21 men; mean age 58 ± 18 years), who underwent endovascular repair using Aegis-B unibody bifurcated stent graft. Narrow proximal landing zone and narrow distal aorta was present in 11 (34.4%) patients and 10 (31.3%) patients, respectively. In the follow-up period, aortic remodeling was observed with computed tomography angiography. Results: All patients were treated by endovascular means, with a primary technical success rate of 100%. During a mean follow-up period of 30.71 ± 16.36 months (range, 8e56 months), no death, rupture, stent fracture, material failure, or device migration was observed. Complete false lumen thrombosis was observed in all patients at 1 year, and all patients were free from false lumen growth in the follow-up. Conclusions: Endovascular treatment of IAAD using the Aegis-B system appears to be safe and effective. Results from this study suggest this algorithm can provide stable, secure fixation for IAAD patients with narrow proximal landing zone, and distal aorta.
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