上海交通大学学报（医学版）

上海交通大学学报（医学版）

• 论著（临床研究） • 上一篇    下一篇

低渗透设计GORE EXCLUDER覆膜支架在复杂腹主动脉瘤腔内治疗中的应用

丁锦辉1,2，刘光2，李维敏2，陆信武2，黄新天2，陆民2，殷敏毅2，施慧华2，刘晓兵2，叶开创2，崔超毅2，黄英2，蒋米尔2   

  1. 1.新疆维吾尔自治区克拉玛依市中心医院普外科， 克拉玛依 83400； 2.上海交通大学 医学院附属第九人民医院血管外科， 上海交通大学血管病诊治中心， 上海 200011
  • 出版日期:2015-04-28 发布日期:2015-04-29
  • 作者简介:丁锦辉（1970—）， 男， 主任医师， 硕士; 电子信箱: djhjq@126.com。

Application of low permeability GORE EXCLUDER aortic covered stent graft to endovascular treatment of complex abdominal aortic aneurysm

DING Jin-hui1,2, LIU Guang2, LI Wei-min2, LU Xin-wu2, HUANG Xin-tian2, LU Min2, YIN Min-yi2, SHI Hui-hua2, LIU Xiao-bing2, YE Kai-chuang2, CUI Chao-yi2, HUANG Ying2, JIANG Mi-er2   

  1. 1.Department of General Surgery, Kelamayi Central Hospital, Kelamayi 834000, China; 2.Department of Vascular Surgery, Center of Vascular Disease, Shanghai Ninth People's Hospital， Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China
  • Online:2015-04-28 Published:2015-04-29

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摘要：

目的 评价低渗透设计GORE EXCLUDER覆膜支架腔内治疗复杂腹主动脉瘤的安全性和有效性。方法 2011年4月—2014年4月应用低渗透设计GORE EXCLUDER覆膜支架腔内治疗复杂腹主动脉瘤21例，收集患者资料并进行回顾性分析。结果 21例患者中，男19例，女2例；年龄55~87岁，中位数为72.34岁。本组病例存在以下1种或多种情况：合并髂动脉瘤10例，巨大动脉瘤4例，短瘤颈3例，瘤颈严重扭曲3例，入路严重扭曲4例，股动脉纤细1例，附壁血栓和严重钙化6例。21例手术均获成功，无中转开腹及术中死亡病例，2例术后住院期间死于合并症。手术时间(135.43±12.45) min，术中出血量为(180.24±21.66) mL，均无输血。术中Ⅰ型内漏5例，Ⅱ型内漏3例，Ⅲ型内漏2例，均术中处理满意。术后随访19例，随访时间为3~36个月,18例存活，1例死于糖尿病并发症。随访患者术后均复查CT血管造影，未发现与支架相关的并发症。结论 低渗透设计GORE EXCLUDER覆膜支架腔内修复适用于多数复杂腹主动脉瘤患者的治疗，手术风险较低，术中和术后并发症较少，具有良好的安全性和有效性。

关键词: 低渗透, GORE EXCLUDER覆膜支架, 复杂腹主动脉瘤, 腔内治疗

Abstract:

Objective To evaluate the safety and effectiveness of the low permeability GORE EXCLUDER aortic covered stent graft for endovascular treatment of complex abdominal aortic aneurysm (AAA). Methods The data of 21 cases of complicated AAA that underwent the endovascular treatment with low permeability GORE EXCLUDER aortic covered stent graft from April, 2011 to April, 2014 were selected and retrospectively analyzed. Results Among 21 patients, 19 of them were males and 2 of them were females. Their ages were between 55 and 87 and the median age was 72.34. Complex AAA included one or more of the following circumstances: combined iliac artery aneurysm (10 cases), giant aneurysm (4 cases), short neck (3 cases), neck severe twisted (3 cases), approach seriously distorted (4 cases), femoral artery slim (1 case), and mural thrombus and severe calcification (6 cases). Operations of all cases were successful without laparotomy and intraoperative deaths and 2 cases died from complications during postoperative hospital stay. Operation time was (135.43±12.45) min and the intra-operative blood loss was (180.24±21.66) mL. No blood transfusion was conducted. There were 5 cases of intra-operative endoleak typeⅠ, 3 cases of endoleak type Ⅱ, and 2 cases of endoleak type Ⅲ. The intra-operative treatment of all cases was satisfactory. A total of 19 patients were followed up for 3-36 months and 18 of them survived and one patient died from the diabetic complication. All postoperatively followed up patients had undergone the computed tomography angiography (CTA) and no significant complications relevant to stents were found. Conclusion The low permeability GORE EXCLUDER aortic covered stent graft is suitable for the treatment of most patients with complex AAA and the safety and effectiveness are satisfactory due to low surgical risk and less intraoperative and postoperative complications.

Key words: low permeability, GORE EXCLUDER covered stent, complex abdominal aortic aneurysm, endovascular treatment