Kasirajan Karthikeshwar
Department of Surgery, Emory University Hospital and Atlanta VA Medical Center, Atlanta, GA 30322, USA.
Semin Vasc Surg. 2006 Mar;19(1):3-10. doi: 10.1053/j.semvascsurg.2005.11.001.
Recent US Food and Drug Administration (FDA) approval of a thoracic endograft has created explosive interest among physicians to learn to use this minimally invasive technology. The level of interest is similar to the period more than a decade ago, following FDA approval of infrarenal abdominal endografts, which initiated the "endo" revolution among vascular specialists. Many physicians view the descending thoracic aorta as a simple, straight tube and, thus, technically less challenging than endografts for infrarenal abdominal aortic aneurysm. However, the thoracic aorta presents certain unique features that make this a challenging procedure. Technical challenges posed by the thoracic aorta have resulted in a significant time-lag (since release of abdominal aortic aneurysm endografts), testing the ability of engineers and physicians to devise and complete trials successful enough for FDA approval of thoracic endografts. This article addresses the various procedural steps and tips on avoiding pitfalls.
美国食品药品监督管理局（FDA）最近批准了一种胸主动脉腔内移植物，这引发了医生们对学习使用这种微创技术的极大兴趣。这种兴趣程度与十多年前类似，当时FDA批准了肾下腹主动脉腔内移植物，引发了血管专科医生之间的“腔内”革命。许多医生将降主动脉视为一根简单的直管，因此，从技术上讲，它比用于治疗肾下腹主动脉瘤的腔内移植物更具挑战性。然而，胸主动脉具有某些独特特征，这使得该手术具有挑战性。胸主动脉带来的技术挑战导致了显著的时间滞后（自腹主动脉瘤腔内移植物推出以来），考验着工程师和医生设计并完成足够成功的试验以获得FDA对胸主动脉腔内移植物批准的能力。本文介绍了各种手术步骤以及避免陷阱的技巧。
