Andrews S M, Freestone T, Pate P, Greenhalgh R M, Nott D M
Department of Surgery, Charing Cross Hospital, London, UK.
Cardiovasc Surg. 1999 Mar;7(2):225-7. doi: 10.1016/s0967-2109(98)00128-8.
to demonstrate the feasibility of minimally invasive approaches to the aorta using retroperitoneal laparoscopy and to clamp the aorta to give views for perfemoral aortic angioscopy.
using retroperitoneal laparoscopy facilitated by balloon dissection the authors developed a new approach to the infrarenal abdominal aorta, in six pigs, to allow control of aortic blood flow. Aortic stent-grafts were then deployed via femoral arteriotomy, and after flushing the blood from the aorta, the stent-grafts were visualized by angioscopy.
accurate positioning and patency of the stent-grafts was ascertained by direct vision angioscopy in all cases.
this series shows that extraperitoneal laparoscopic aortic dissection is feasible and direct endovascular visualization of the aortic lumen can be performed. This may find a role as an adjunct to endovascular techniques such as endovascular stent-graft placement, by aortic angioscopy following minimally-invasive aortic clamping.
证明使用腹膜后腹腔镜对主动脉进行微创入路的可行性，并夹闭主动脉以提供经股动脉主动脉血管镜检查的视野。
作者利用球囊分离辅助的腹膜后腹腔镜技术，在六头猪身上开发了一种新的入路至肾下腹主动脉，以控制主动脉血流。然后通过股动脉切开术植入主动脉覆膜支架，在冲洗主动脉内的血液后，通过血管镜观察覆膜支架。
在所有病例中，通过直视血管镜确定了覆膜支架的准确定位和通畅情况。
本系列研究表明，腹膜外腹腔镜主动脉分离术是可行的，并且可以对主动脉管腔进行直接的血管内可视化。通过微创主动脉夹闭后的主动脉血管镜检查，这可能作为血管内技术（如血管内覆膜支架置入）的辅助手段发挥作用。
