Gawenda Michael, Aleksic Marko, Heckenkamp Jörg, Krüger Karsten, Brunkwall Jan
Division of Vascular Surgery, University of Cologne, Cologne, Germany.
J Thorac Cardiovasc Surg. 2005 Oct;130(4):1039-43. doi: 10.1016/j.jtcvs.2005.05.042.
Late aneurysm formation has been reported after every type of surgical coarctation repair, with rupture of such aneurysms being responsible for approximately 7% of all deaths. Secondary surgical repair carries a significant mortality and morbidity. According to the positive experience with endovascular therapy of atherosclerotic thoracic aortic aneurysms, it is worthwhile to evaluate the concept of minimally invasive endovascular stent grafting for secondary repair of postsurgical aneurysms.
Data were collected prospectively on consecutive patients who presented with postcoarctation false aneurysms.
Since 1999, in a cohort of 46 endovascularly treated patients with thoracic aortic pathologies, 3 patients with postcoarctation false aneurysms underwent endoluminal stent-graft placement. All of these procedures were technically successful without 30-day or 1-year procedure-related mortality. After a mean follow-up of 19 months (range, 7.8-33.5 months), all aneurysm remain excluded without endoleak.
According to the current limited experience of small series and short periods of follow-up, the endoluminal repair seems to be a promising alternative to redo operations for postsurgical thoracic aneurysms associated with coarctation repair. Long-term follow-up is required to assess the durability of the stent-graft treatment.
据报道，每种类型的外科缩窄修复术后均会出现晚期动脉瘤形成，此类动脉瘤破裂导致的死亡约占总死亡人数的7%。二次外科修复具有较高的死亡率和发病率。鉴于血管内治疗胸主动脉粥样硬化性动脉瘤取得了积极经验，评估采用微创血管内支架植入术对术后动脉瘤进行二次修复的概念是值得的。
前瞻性收集连续出现缩窄后假性动脉瘤患者的数据。
自1999年以来，在一组46例接受血管内治疗的胸主动脉病变患者中，3例缩窄后假性动脉瘤患者接受了腔内支架植入术。所有这些手术在技术上均获成功，无30天或1年的手术相关死亡率。平均随访19个月（范围7.8 - 33.5个月）后，所有动脉瘤均保持隔绝状态，无内漏。
根据目前小样本系列和短期随访的有限经验，腔内修复似乎是与缩窄修复相关的术后胸主动脉瘤再次手术的一种有前景的替代方法。需要进行长期随访以评估支架植入治疗的耐久性。
