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支架型人工血管治疗主动脉夹层动脉瘤7例

陕西医学杂志 2005年第2期34卷 172-174页

作者：鲍学斌翟保平翟水亭曹会存河南省人民医院普外科郑州450003 河南省人民医院介入科

目的 :介绍应用支架型人工血管治疗夹层动脉瘤的初步经验。方法 :7例支架型人工血管在全麻或硬膜外麻醉下经一侧股动脉切开置入在病变部位。结果 :腔内技术成功率 1 0 0 % ,无瘤体破裂 ,无截瘫等严重并发症 ,无围手术期死亡。2例因破口... 详细信息

目的 :介绍应用支架型人工血管治疗夹层动脉瘤的初步经验。方法 :7例支架型人工血管在全麻或硬膜外麻醉下经一侧股动脉切开置入在病变部位。结果 :腔内技术成功率 1 0 0 % ,无瘤体破裂 ,无截瘫等严重并发症 ,无围手术期死亡。2例因破口位置高 ,封堵左锁骨下动脉 1例 ,应用分支型支架人工血管 1例。随访 1～ 1 8个月 ,经螺旋 CT证实无内漏及支架移位等并发症发生。结论 :支架型人工血管治疗夹层动脉瘤是一种安全、可靠。

关键词：治疗支架型人工血管主动脉夹层动脉瘤严重并发症置入瘤体破裂腔内技术结论实用目的

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支架型人工血管治疗创伤性股动静脉瘘

中国微创外科杂志 1997年第1期 32-34页

作者：陈学明汪忠镐王仕华喻金弟北京邮电总医院血管外科研究所 100032 北京高忆公司

近年来,血管腔内技术(EVT)发展迅速,各种支架型人工血管以介入法进行放置,用以治疗许多血管疾病累有成功报导,既避免了手术和危险,又明显缩短了住院时间。本文报告用编织式镍钛记忆金属支架带丝绸人工血管经腔内治疗创伤性股动静脉瘘1... 详细信息

近年来,血管腔内技术(EVT)发展迅速,各种支架型人工血管以介入法进行放置,用以治疗许多血管疾病累有成功报导,既避免了手术和危险,又明显缩短了住院时间。本文报告用编织式镍钛记忆金属支架带丝绸人工血管经腔内治疗创伤性股动静脉瘘1例并作文献复习。

关键词：支架型人工血管治疗创伤动静脉瘘记忆金属编织式送器血管腔内技术真丝内膜增生经腔

支架型人工血管介入治疗6例降主动脉假性动脉瘤患者

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中华急诊医学杂志 2005年第7期14卷 587-589页

作者：刘彤李志忠许尚栋白树功马临安王苏李勇陶英首都医科大学附属北京安贞医院北京市心肺血管疾病抢救中心首都医科大学附属北京安贞医院心脏外科

目的探讨支架型人工血管介入治疗降主动脉假性动脉瘤的可行性及疗效。方法2001年9月至2004年9月,用支架型人工血管治疗降主动脉假性动脉瘤患者6例。4例病因为外伤,2例病因不明,3例行急诊手术。6例为男性,年龄(42.2±15.2)岁;瘤体直径(5.... 详细信息

目的探讨支架型人工血管介入治疗降主动脉假性动脉瘤的可行性及疗效。方法2001年9月至2004年9月,用支架型人工血管治疗降主动脉假性动脉瘤患者6例。4例病因为外伤,2例病因不明,3例行急诊手术。6例为男性,年龄(42.2±15.2)岁;瘤体直径(5.0±1.1)cm。结果支架型人工血管均顺利植入。1例有近端内漏,术后30d内无死亡。术后随诊(9.3±10.7)个月。1例于术后4个月死亡,1例于5个月后因再发假性动脉瘤接受再次支架型血管植入术。结论支架型人工血管是治疗主动脉假性动脉瘤的有效方法,但中远期效果还有待进一步观察。

关键词：降主动脉假性动脉瘤血管介入治疗患者支架型人工血管 2004年 2001年血管植入术病因不明急诊手术瘤体直径术后随诊远期效果无死亡

应用支架型人工血管治疗主动脉夹层45例报告

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中国实用外科杂志 2003年第12期23卷 742-744页

作者：张小明张学民李伟李清乐蒋京军焦洋沈晨阳袁链汪忠镐北京大学人民医院血管外科 100044 浙江大学医学院附属第一医院血管外科杭州310003

目的　探讨支架型人工血管治疗主动脉夹层的临床效果。方法　 2 0 0 1年 3月至 2 0 0 3年 9月间 ,应用支架型人工血管治疗Ⅲ型夹层 44例和Ⅰ型主动脉夹层 1例。 45例主动脉夹层共应用 56个支架型人工血管行近侧内膜破口封堵 ,1例同时行... 详细信息

目的　探讨支架型人工血管治疗主动脉夹层的临床效果。方法　 2 0 0 1年 3月至 2 0 0 3年 9月间 ,应用支架型人工血管治疗Ⅲ型夹层 44例和Ⅰ型主动脉夹层 1例。 45例主动脉夹层共应用 56个支架型人工血管行近侧内膜破口封堵 ,1例同时行远侧内膜破口手术关闭 ,1例远侧破口以分叉的支架型人工血管封闭。结果　所有病人均获得技术成功。围手术期死亡 2例 ,1例术后 12h后死于脑出血 ,1例术后 10d死于假腔破裂 ;1例手术后半年死于细菌性心内膜炎。结论　支架型人工血管行Ⅲ型主动脉夹层和破口在降主动脉的Ⅰ型主动脉夹层破口封堵术较传统手术安全。

关键词：应用支架型人工血管治疗主动脉夹层血管内膜破口

支架型人工血管治疗DeBakeyⅢ型主动脉夹层后的主动脉重构

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同济大学学报（医学版） 2013年第3期34卷 81-85页

作者：周涛徐彬沈通一厦门大学附属福州第二医院血管外科福建福州350000 同济大学附属第十人民医院普外科上海200072

目的探讨支架型人工血管(stent-grafts)治疗DeBakeyⅢ型主动脉夹层术后夹层真假腔转归变化和主动脉重构情况。方法分析2003年2月到2008年3月有完整住院资料及随访资料的112例Ⅲ型主动脉夹层患者资料。经支架型人工血管治疗的112例主动... 详细信息

目的探讨支架型人工血管(stent-grafts)治疗DeBakeyⅢ型主动脉夹层术后夹层真假腔转归变化和主动脉重构情况。方法分析2003年2月到2008年3月有完整住院资料及随访资料的112例Ⅲ型主动脉夹层患者资料。经支架型人工血管治疗的112例主动脉夹层患者(平均56.6岁,男性94例)中,急性期病例54例(48.2%,平均63.8 h),慢性期58例(51.8%,平均22.3个月)。影像学观察术后夹层的形态学改变及假腔内血栓形成情况,测量主动脉不同部分真腔(true lumen TL),假腔(false lumen FL)及主动脉腔(whole lumen WL)直径的改变并计算真腔指数(TL index TLi)和假腔指数(FL index FLi),统计分析用配对t检验和χ2检验。结果平均随访25个月,术后TLi明显增加,FLi明显降低,差别有统计学意义。结论血管腔内支架型人工血管治疗主动脉DeBakeyⅢ型夹层可封闭原发破口,使真腔增大,假腔减小并血栓形成,主动脉重构以恢复正常血流动力学。

关键词：主动脉夹层支架型人工血管主动脉重构

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支架型人工血管治疗肾下腹主动脉瘤一例

中华外科杂志 2010年第23期48卷 1825-1825页

作者：马杰飞符伟国徐欣杨珏石赟李炜淼王玉琦复旦大学附属中山医院血管外科上海200032

患者男性，70岁，因“不明原因右侧腰背部疼痛1个月余”于2010年5月5日入院，患者无发热、寒战、腹痛症状，外院CT血管造影（CTA）提示肾下腹主动脉瘤及髂动脉瘤（图1）。既往有高血压病史。体检无明显阳性体征。术前诊断为：肾下腹主... 详细信息

患者男性，70岁，因“不明原因右侧腰背部疼痛1个月余”于2010年5月5日入院，患者无发热、寒战、腹痛症状，外院CT血管造影（CTA）提示肾下腹主动脉瘤及髂动脉瘤（图1）。既往有高血压病史。体检无明显阳性体征。术前诊断为：肾下腹主动脉瘤及双侧髂总动脉瘤。2010年5月12日在气管插管联合静脉麻醉下显露双侧股总动脉，静脉注射50mg肝素，双侧股动脉均放置动脉鞘。

关键词：肾下腹主动脉瘤支架型人工血管治疗 CT血管造影腰背部疼痛高血压病史髂总动脉瘤不明原因

血管内置入支架型人工血管治疗穿透性主动脉溃疡:中位时间为27个月的随访研究结果

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世界核心医学期刊文摘（心脏病学分册） 2006年第6期2卷 27-28页

作者： Eggebrecht H. Herold U. Schmermund A. 田雨灵(译) 任付先(校) Department of Cardiology University of Duisburg- Essen Hufelandstrafle 55 45122 Essen Germany 不详

Background: Penetrating aortic ulcer(PAU) is increasingly acknowledged as a pathological variant of classic false- lumen aortic dissection with a high incidence of bleeding complications and rupture in up to 40% of patients. The objective of this study was to investigate the results of endovascular stent- graft placement for the treatment of patients with PAUs. Methods: Between July 1999 and December 2004, endovascular stent- graft repair of PAU was performed in 22 patients(69.1± 7.8 years, 16 men), 3(14% ) of whom had contained aortic rupture. Stent- graft placement was performed in the cardiac catheterization laboratory with the patient under general anesthesia, using a surgical access. Results: Procedural success was achieved in all but 1 patient(technical success rate 96% ). Postoperatively, 1(5% ) patient had minor stroke with transient amentia. There were no other inhospital complications or deaths. During a median follow- up of 27(range 1- 62) months, 1 patient underwent adjunctive stent- graft placement for type I endoleak. Three patients died unrelated to the aortic disease late during follow- up. Overall survival rates were 100% at 30 days, 100% at 1 year, 82.5% ± 11.3% at 2 years, and 61.9% ± 20.0% at 5 years. Conclusions: Endovascular stent- graft treatment is an effective treatment for patients with PAU and is associated with low procedural morbidity. Both acute and midterm mortality of this novel treatment concept appear to be favorable compared with the natural course of the disease.

关键词：支架型人工血管血管内置入主动脉夹层随访研究修复治疗中位时间穿透性溃疡主动脉破裂出血性并发症

利用Talent Thoracic支架型人工血管行血管内胸主动脉修补的效果:Talent Thoracic回顾性注册研究

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世界核心医学期刊文摘（心脏病学分册） 2006年第11期2卷 61-62页

作者： Fattori R. Nienaber C.A. Rousseau H. 张步升 Cardiovascular Radiology University Hospital S. Orsola Bologna Italy Dr.

Background: Endovascular treatment of thoracic aortic diseases demonstrated low perioperative morbidity and mortality when compared with conventional open repair. Long-term effectiveness of this minimally invasive technique remains to be proven. The Talent Thoracic Retrospective Registry was designed to evaluate the impact of this therapy on patients treated in 7 major European referral centers over an 8-year period. Methods: Data from 457 consecutive patients (113 emergency and 344 elective cases) who underwent endovascular thoracic aortic repair with the Medtronic Talent Thoracic stent graft (Medtronic/AVE, Santa Rosa, Calif) were collected. Follow-up analysis (24±19.4 months, range 1-85.1 months)was based on clinical and imaging findings, including all adverse events. To ensure consistency of data interpretation and event reporting, one physician reviewed all adverse events and deaths for the whole cohort of patients. In the case of discrepancies, the treating physicians were queried. Findings: Among 422 patients who survived the interventional procedure (in-hospital mortality 5%, 23 patients), mortality during follow-up was 8.5%(36 patients), and in 11 of them the death was related to the aortic disease. Persistent endoleak was reported at imaging follow-up in 64 cases: 44 were primary (9.6%) and 21 occurred during follow-up (4.9%). Seven patients with persistent endoleak had aortic rupture during follow-up, at a variable time from 40 days to 35 months, and all subsequently died. A minor incidence of migration of the stent graft (7 cases), graft fabric alteration (2 cases), and modular disconnection (3 cases) was observed at imaging. Kaplan-Meier overall survival estimate at 1 year was 90.97%, at 3 years was 85.36%, and at 5 years was 77.49%. At the same intervals, freedom from a second procedure (either open conversion or endovascular) was 92.45%, 81.3%, and 70.0%, respectively. Conclusion: Endovascular treatment for thoracic aortic disease with the Talent stent graft is associated with low early morbidity a

关键词：支架型人工血管胸主动脉 Talent 主动脉疾病随访分析影像学检查经治医师择期手术主动脉

通过置入支架型人工血管行全主动脉弓置换的方法广泛一期修复胸主动脉以治疗急性A型主动脉夹层的中期预后

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世界核心医学期刊文摘（心脏病学分册） 2006年第9期2卷 60-60页

作者： Uchida N. Ishihara H. Shibamura H. 马超 Division of Cardiovascular Surgery Hiroshima-city Asa General Hospital2-1-1Kabe-minamiAsa-Kita-KuHiroshima731-0293Japan.Dr

Objectives: We sought to describe the midterm results of extensive primary rep air of the thoracic aorta by means of the modified elephant trunk technique with a stent graft for acute type A aortic dissection, particularly the changes of t he false lumen shown by enhanced computed tomographic scanning. Methods: The sub jects were 35 consecutive patients who received arch replacement with open stent grafting for type A acute aortic dissection between December 1997 and April 200 2. The mean follow-up period was 55 months (range, 30-83 months). Computed tom ographic scanning was performed at 1, 3, 12, and 36 months postoperatively to de tect thrombosis and obliteration of the false lumen after its exclusion by the s tent graft. The diameter of the aorta was measured at 3 levels: the distal edge of the stent graft, the diaphragm, and the origin of the superior mesenteric art ery. Results: Two patients died in the initial operation, but no patients requir ed additional surgical treatment of the thoracic aorta. The mean diameter of the stent grafts was 26.2 mm, and the mean length was 8.9 cm. Thrombus formation in the false lumen was recognized at the distal edge of the graft in all patients, at the diaphragmatic level in 26 patients, and at the superior mesenteric arter y level in 15 patients. Obliteration of the false lumen was recognized at the di stal edge of the graft in all patients, at the diaphragmatic level in 20 patient s, and at the superior mesenteric artery level in 15 patients. The aorta distal to the stent graft showed minimal changes. Conclusions: In patients with acute t ype A aortic dissections, it is possible to perform extensive primary repair of the thoracic aorta with relative safety by using a synthetic graft with a self- expanding stent, and this method might reduce the necessity of further operation s not only for the distal descending aorta but also for the thoracoabdominal aor ta.

关键词：支架型人工血管 A型主动脉夹层主动脉弓置换胸主动脉一期修复治疗后预后中期