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[血管腔内主动脉支架假体置入后的中期并发症及问题]

[Intermediate-term complications and problems after endovascular aortic stent prostheses].

作者信息

Umscheid T, Stelter W J, Ziegler P

机构信息

Chirurgische Klinik, Städtische Klinik Frankfurt-Höchst, Frankfurt/M.

出版信息

Zentralbl Chir. 2000;125(1):7-14.

Abstract

From August 1994 to December 1998 321 patients were treated with endovascular stentgrafts for aortic aneurysm exclusion in our hospital. Primary exclusion rate was 91% (primary leakage 8.7%) and hospital mortality was 3.7%. 6 different types of grafts were used, 5 of them commercially available. Midterm complications are due to configuration changes of the grafts, material deterioration, side branch reperfusion and changes in aortic morphology. The common pattern of clinical expression of these complications is secondary leakage (60 cases) and graft limb occlusion (37 occurrences in 30 patients). 50% of the secondary endoleaks have been treated up to now leaving the remaining patients under a thorough follow-up. Graft limb thrombosis was treated in all but three, well compensated, patients. Midterm results of the first commercially available endografts are not yet satisfying in contrast to conventional aortic repair. The recently available grafts are promising as they have a better kink resistance, no graft sutures and fewer modular components.

摘要

1994年8月至1998年12月,我院对321例患者采用血管内支架型人工血管进行主动脉瘤隔绝术。一期隔绝成功率为91%(一期内漏发生率为8.7%),住院死亡率为3.7%。使用了6种不同类型的人工血管,其中5种为市售产品。中期并发症是由于人工血管构型改变、材料退变、分支再灌注及主动脉形态改变所致。这些并发症的常见临床表现形式为继发性内漏(60例)和人工血管肢体闭塞(30例患者发生37次)。目前,50%的继发性内漏已得到治疗,其余患者仍在接受密切随访。除3例病情得到良好控制的患者外,其余人工血管肢体血栓形成患者均接受了治疗。与传统主动脉修复术相比,首批市售腔内移植物的中期结果尚不尽人意。最近上市的移植物前景良好,因为它们具有更好的抗扭结性能、无移植物缝线且组件较少。

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