高危胸降主动脉瘤腔内修复治疗 - 先健科技.pdf

2007 12 15 6　ChinJInterventCardio,lDecember2007, ol15, No.6 ·3 13 · ·· ■ 施德兵　符伟国 　王玉琦　陈斌　郭大乔　徐欣　蒋俊豪　杨珏　史振宇　董智慧 竺挺　李炜 　　【】　　(descendingthoracicaorticaneurysm, DTAA) (endovascularaneurysmrepai,rEAR)。　 2001 1 2007 7 24 DTAA EAR、。、、 。 EAR 1、3、6、12 CT 、。　(100%)。 2 (8.3%), 。 2 (8.3%)(1 1)。 11(4 6%)Ⅰ, 3 , ; 8。 19 , 1 ～60 ( 18.6 ±4.2 )。 1 4 Ⅰ, 1 2 Ⅲ, EAR。 1。 3 CT, 。 0 ～ 18 mm( 6.3 ±3.1 mm), 4 。　EAR DTAA, 。 【】　, ;;; Clinicaloutcomesofendovascularrepairofdescendingthoracicaorticaneurysm inhigh-riskpatients 　SHIDebing, FUWeiguo, WANGYuq,ieta.lDeparmtentofascularSurgery, ZhongshanHospita,l FudanUniversity, Shanghai200032, China 【Abstract】　Objective　Toevaluatethemid-term outcomesofendovascularrepairofdescending thoracicaorticaneurysm (DTAA)inhigh-riskpatients.Methods　TwentyfourpatientswithDTAA receivedstent-graftsmiplantationbetweenJanuary2001 andJuly2007 andtheirclinicaldatawere retrospectivelyanalyzed.Allpatientswereconsideredhigh-riskforopensurgicalrepairduetothelocationor ruptureoftheaneurysm, highageandseverecomorbidities.Spiralcomputedtomographyangiographyand3- dmientionalreconstructionswereperformedat1, 3, 6 and12 monthspostoperativelyandthereafterevery year.Results　Theprmiaryoperationalsuccessratewas100%.Therewere2 deaths(8.3%)during perioperativeperiodduetomultiorganfailureandacutemyocardialinfarctionrespectively.Two(8.3%) patientshadseverepost-operationalcomplications(1 strokeand1 acuterenalinsufficiency).Elevencases oftypeⅠ (46%)endoleakweredetectedimmediatelyaftertheoperationandamongthem, theendoleak disappearedafterballoondilatationin3 caseswhiletheother8 patientsweretreatedconservatively.Follow- upof1 to60 months(mean18.6 ±4.2 months)wascompletedin19 patients(79.2%).Stent displacementwithtypeⅠ endoleakewasfoundin1 patientat4 yearsaftertheoperationanddelayedtypeⅢ endoleakoccur