烟囱技术在血管内修复鞍旁主动脉瘤的疗效观察。

K. Igari, T. Kudo, T. Toyofuku, Y. Inoue
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引用次数: 19

摘要

目的总结烟囱技术联合血管内动脉瘤修复术(Ch-EVAR)治疗肾旁主动脉瘤(JAAs)的经验,并对其疗效进行总结。方法回顾性分析2012年1月~ 2015年12月行Ch-EVAR治疗的患者。所有患者均在全身麻醉下行血管内动脉瘤修复术(EVAR)。获得股动脉通道放置内移植物主体;获得肱或腋窝通道以放置烟囱支架。结果采用Ch-EVAR手术治疗了12例15条肾动脉。12例中有11例(91.6%)技术成功。术后30天内,靶血管通畅率为93.3%(15条肾动脉中14条)。中位随访28个月后,1例患者因Ia型内漏需要ch - evar相关的再干预,随访结束时15条肾动脉中有13条通畅。结论Ch-EVAR手术成功率高。虽然可能会发生早期靶血管闭塞或术后早期死亡,但Ch-EVAR可能是JAA的替代治疗方法,特别是在高危患者中。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The Outcomes of Endovascular Aneurysm Repair with the Chimney Technique for Juxtarenal Aortic Aneurysms.
PURPOSE We collected our experience in the use of chimney technique with endovascular aneurysm repair (Ch-EVAR) for juxtarenal aortic aneurysms (JAAs), and reviewed the outcomes. METHODS The patients who were treated with Ch-EVAR between January 2012 and December 2015 were retrospectively reviewed. All of the patients underwent endovascular aneurysm repair (EVAR) under general anesthesia. Femoral arterial access was obtained to place the main body of the endograft; brachial or axillary access was obtained to perform the placement of the chimney stent. RESULTS We treated 12 patients with 15 renal arteries using the Ch-EVAR procedure. Technical success was achieved in 11 of the 12 (91.6%) cases. Within the first 30 days of postoperative period, the target vessel patency rate was 93.3% (14 of 15 renal arteries). After a median follow-up period of 28 months, one patient required Ch-EVAR-related re-intervention due to a type Ia endoleak, and 13 of the 15 renal arteries were patent at the end of the follow-up period. CONCLUSION Our findings demonstrate that Ch-EVAR can be completed with a high rate of success. Although early target vessel occlusion or early postoperative mortality might occur, Ch-EVAR could be an alternative treatment for JAA, especially in high risk patients.
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