Yang Dai-hua, Guo Wei, Liu Xiao-ping, Yin Tai, Jia Xin, Zhang Hong-peng, Wang Wei, Zhang Guo-hua, Liang Fa-qi
Department of Vascular Surgery, the General Hospital of People's Liberation Army, Beijing 100853, China.
Zhonghua Wai Ke Za Zhi. 2007 Oct 1;45(19):1346-9.
To design and manufacture a modular branched stent-graft system of endovascular reconstruction of the aortic arch in canine, and to investigate the feasibility of endovascular repair.
After the length and the diameter of ascending aorta, aortic arch and super-arch branched vessel measurement, a modular branched stent-graft system, including two pieces bifurcated stent-graft and one piece straight stent-graft, was designed and manufactured. Under X-ray fluorescope, these three modulars were accessed from right subclavian, left subclavian and femoral artery respectively and connected one by one to reconstruct the aortic arch. The shape and structure of stent-grafts, haemodynamics in aortic arch and endoleak were observed.
Eight of ten operations were completed successfully. Two dogs died of obstruction of coronary artery and artery rupture of left subclavian respectively during operation. In the eight successful cases, two proximal type I endoleaks were observed, and no other type endoleak occurred. The shape and the localization of stent-grafts were fine, and the coronary artery and carotid artery were unobstructed.
It is feasible to reconstruct aortic arch of canine by modular branched stent-graft, and it is significant to direct the research of reconstruction of human aortic arch.
设计并制造一种用于犬主动脉弓血管腔内重建的模块化分支支架型人工血管系统，并探讨血管腔内修复的可行性。
在测量犬升主动脉、主动脉弓及弓上分支血管的长度和直径后，设计并制造了一种模块化分支支架型人工血管系统，包括两件分叉型支架型人工血管和一件直型支架型人工血管。在X线透视下，分别经右锁骨下动脉、左锁骨下动脉和股动脉置入这三个模块，并依次连接以重建主动脉弓。观察支架型人工血管的形态和结构、主动脉弓内的血流动力学及内漏情况。
10例手术中8例成功完成。2只犬分别在手术过程中死于冠状动脉阻塞和左锁骨下动脉破裂。在8例成功病例中，观察到2例近端I型内漏，未发生其他类型内漏。支架型人工血管的形态和定位良好，冠状动脉和颈动脉未受阻。
采用模块化分支支架型人工血管重建犬主动脉弓是可行的，对指导人体主动脉弓重建的研究具有重要意义。
