Shimono T, Kato N, Hirano T, Takeda K, Yada I
Dept. of Thoracic and Cardiovascular Surgery, Mie University School of Medicine, Tsu, Japan.
Nihon Geka Gakkai Zasshi. 1999 Aug;100(8):500-5.
Early and mid-term clinical results of 28 cases of endovascular stent grafting for descending thoracic aortic aneurysms and 11 cases of abdominal aortic aneurysms are reported. Early clinical results: Among 28 patients (7 true thoracic aortic aneurysms, 3 pseudothoracic aortic aneurysms and 8 acute, 4 subacute, and 6 chronic aortic dissections), two patients (7.1%) with ruptured acute aortic dissection or ruptured infected pseudoaneurysm died in the perioperative period. Two of the remaining 26 patients experienced minor complications. Aneurysmal sacs or false lumens at the descending thoracic aorta were completely thrombosed in the 26 patients. One patient (9.1%) with a ruptured abdominal aneurysm died, and one of the remaining 10 patients had renal and peripheral emboli and peripheral vascular trauma. Inadvertent covering of the renal arteries occurred in another patient. Unless one patient had persistent endoleak, aneurysmal sacs in the 10 surviving patients were thrombosed. Mid-term clinical results: One aortic dissection at a different section of the descending aorta occurred 6 months after stent grafting for aortic dissection, and one patient died of pneumonia 3 months after stent grafting for an abdominal aortic aneurysm. CT scanning 6 months after stent grafting revealed a decrease in maximal aneurysmal size in 3 of 9 patients with true or pseudothoracic aneurysms and in 2 of 5 patients with abdominal aortic aneurysms. Five of 9 patients with stent grafting for acute or subacute dissection showed elimination of the false lumen in the descending thoracic aorta in a CT scan 6 months after grafting. One patient with a true thoracic aneurysm and one patient with an abdominal aortic aneurysm showed an increase in aneurysmal size in a CT scan 2 years and one year after treatment, respectively.
报告了28例降主动脉瘤和11例腹主动脉瘤血管内支架植入术的早期和中期临床结果。早期临床结果：28例患者中（7例真性胸主动脉瘤、3例假性胸主动脉瘤以及8例急性、4例亚急性和6例慢性主动脉夹层），2例急性主动脉夹层破裂或感染性假性动脉瘤破裂患者在围手术期死亡（7.1%）。其余26例患者中有2例出现轻微并发症。26例患者降主动脉的瘤腔或假腔完全血栓形成。1例腹主动脉瘤破裂患者死亡（9.1%），其余10例患者中有1例出现肾和外周栓塞以及外周血管损伤。另1例患者出现肾动脉意外覆盖。除1例患者存在持续性内漏外，1生的10例患者的瘤腔均血栓形成。中期临床结果：1例主动脉夹层患者在支架植入术后6个月降主动脉不同节段出现新的夹层，1例腹主动脉瘤患者在支架植入术后3个月死于肺炎。支架植入术后6个月的CT扫描显示，9例真性或假性胸主动脉瘤患者中有3例、5例腹主动脉瘤患者中有2例最大瘤体尺寸减小。9例急性或亚急性夹层支架植入患者中有5例在术后6个月的CT扫描显示降主动脉假腔消失。1例真性胸主动脉瘤患者和1例腹主动脉瘤患者分别在治疗后2年和1年的CT扫描显示瘤体增大。
