Ishimaru Shin
Department of Surgery II, Tokyo Medical University, Tokyo, Japan.
J Endovasc Ther. 2004 Dec;11 Suppl 2:II62-71. doi: 10.1177/15266028040110S614.
In recent years, endovascular repair with stent-grafts has made great advances as a minimally invasive alternative to conventional open surgery in the treatment of aortic aneurysm and dissection. Although many commercial endograft systems are now used worldwide for the treatment of these pathologies in the abdominal aorta, only a few dedicated stent-grafts have been developed for use in the thoracic aorta. However, these second-generation commercial endografts have almost identical specifications and performance profiles in terms of structure, function, and delivery mechanism as stent-graft systems employed in the abdominal aorta. Thus, endografts have been used in the thoracic aorta with little consideration to the morphological and hemodynamic characteristics specific to the aortic arch and the deployment techniques needed to navigate this curved region of the thoracic aorta. This review will survey the literature on aortic arch stent-graft repair and identify key elements critical to the successful design of an endograft to treat lesions in the aortic arch.
近年来，作为治疗主动脉瘤和主动脉夹层的传统开放手术的微创替代方法，带覆膜支架血管内修复术取得了长足进展。尽管目前全球有许多商用腔内移植物系统用于治疗腹主动脉的这些病变，但仅有少数专用覆膜支架用于胸主动脉。然而，这些第二代商用腔内移植物在结构、功能和输送机制方面的规格和性能与用于腹主动脉的覆膜支架系统几乎相同。因此，在将腔内移植物用于胸主动脉时，几乎没有考虑到主动脉弓特有的形态学和血流动力学特征以及在这个胸主动脉弯曲区域进行植入所需的技术。本综述将调查有关主动脉弓覆膜支架修复术的文献，并确定成功设计用于治疗主动脉弓病变的腔内移植物的关键要素。
