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腹主动脉瘤的血管内治疗

[Endovascular management of abdominal aortic aneurysm].

作者信息

Krasiński Zbigniew, Staniszewski Ryszard, Juszkat Robert, Woo Edward Y, Majewski Wacław

机构信息

Akademia Medyczna w Poznaniu, Klinika Chirurgii Ogólnej i Naczyń.

出版信息

Pol Merkur Lekarski. 2006 Jan;20(115):88-92.

Abstract

Not all patients with abdominal aortic aneurysm (AAA) are candidates for endovascular aneurysm repair (EVAR), but as further technologic refinements occur, it is likely that an increasing percentage of patients will be candidates. EVAR, pioneered by Parodi in early 1990s, has made significant progress in all aspects. In the early stages of development, stent grafts were used only to repair abdominal aortic aneurysms (AAAs) in patients with comorbidities (e.g. chronic obstructive pulmonary disease or myocardial infarction) significant enough to preclude open repair. With the advent of new technology, the rapid spread of the skill sets needed to place these grafts, and the demonstration that these grafts are not only safe but also durable, EVAR is now being used more commonly in patients who would otherwise undergo open repair. Nevertheless, EVAR is still in the early stages of development, and long-term follow-up of EVAR patients is essential to assure durable protection from AAA rupture. The authors present the review of epidemiology and possibilities of endovascular management of abdominal aortic aneurysm.

摘要

并非所有腹主动脉瘤(AAA)患者都适合接受血管内动脉瘤修复术(EVAR),但随着技术的进一步完善,适合该手术的患者比例可能会不断增加。20世纪90年代初由帕罗迪开创的EVAR在各个方面都取得了重大进展。在发展的早期阶段,支架移植物仅用于修复患有严重合并症(如慢性阻塞性肺疾病或心肌梗死)而无法进行开放修复的腹主动脉瘤(AAA)患者。随着新技术的出现、放置这些移植物所需技能的迅速普及,以及这些移植物不仅安全而且耐用的证明,EVAR现在越来越普遍地用于那些原本会接受开放修复的患者。然而,EVAR仍处于发展的早期阶段,对接受EVAR治疗的患者进行长期随访对于确保持久预防AAA破裂至关重要。作者对腹主动脉瘤的流行病学及血管内治疗的可能性进行了综述。

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