一体式分叉型覆膜支架在介入治疗孤立性髂动脉瘤中的应用
【摘要】目的 探讨一体式分叉型覆膜支架应用于介入治疗孤立性髂动脉瘤(IIAAs)的安全及有效性。方法 回顾性分析本中心自2011年8月至2016年7月,共7例男性患者,年龄49~22岁,平均年龄(69±10.5)岁,因IIAAs接受一体式分叉型覆膜支架介入治疗。其中单侧病变3例;双侧病变4例,4 例合并髂内动脉瘤。6例患者使用Microport Aegis-B—体式分叉型覆膜支架,1例使用Powerlink一体式分叉型覆膜支架,远端共使用9枚髂动脉延长支架。1例患者行髂内动脉预栓塞以避免II型内漏。术后分别于1、6、12个月及以后每年一次行临床及影像随访。结果:7例患者均成功置入一体式覆膜支架,技术成功率为100%。一体式支架主体近端直径为24~26 mm,长度为80~92 mm。6例患者单侧髂内动脉开口覆盖,1例患者双侧髂内动脉开口覆盖,无盆腔及臀肌缺血发生,围术期无严重并发症发生。平均随访时间(32.55±19)个月(12~70个月)。患者随访期内无支架移位,无支架相关死亡等严重并发症。1例随访内发现轻度II型内漏。结论 一体式分叉型覆膜支架治疗IIAAs安全有效,近中期疗效满意,特别是对于近端锚定区不足或双侧受累的患者有其独到特殊的应用优势。
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一体式分叉型覆膜支架在腹主动脉及髂动脉病变腔内治疗中的应用
【摘要】目的 探讨一体式分叉型覆膜支架治疗腹主动脉及骼动脉病变的疗效。方法 本组31例患者应用一体式分叉型覆膜支架治疗,男26例,女5例;年龄38~84岁,平均(64.5±10.7)岁。腹主动脉真性动脉瘤17例,腹主动脉穿通溃疡5例,髂动脉瘤4例(双侧受累2例),腹主动脉假性动脉瘤2例,腹主动脉瘤EVAR术后远端漏2例,腹主动脉夹层1例。使用Microport Aegis(上海微创)支架22例,Powerlink(ENDOLOGIX公司)支架9例。术后1、3、6、12个月及以后每年一次行检查随访。结果 31例均成功置入支架,手术成功率100%。覆膜支架主体近端直径20~28 mm,主体支架长度120~240 mm;封闭一侧髂内动脉13例,双侧动内动脉均保留15例。随访3~36个月,支架内血流通畅,无内漏及支架移位发生。结论 一体式分叉型覆膜支架治疗肾下腹主动脉病变及动动脉病变近中期疗效满意,远期疗效尚需长期随访。
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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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