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覆膜支架在外周非动脉粥样硬化性动脉病变中的应用。

Stent-graft applications in peripheral non-atherosclerotic arterial lesions.

作者信息

Peynircioğlu Bora, Ergun Onur, Hazirolan Tuncay, Serter Tanzer, Uçar Ibrahim, Cil Barbaros, Cekirge Saruhan

机构信息

Department of Radiology, Hacettepe University School of Medicine, Ankara, Turkey.

出版信息

Diagn Interv Radiol. 2008 Mar;14(1):40-50.

Abstract

PURPOSE

To retrospectively evaluate peripheral arterial lesions treated with stent-grafts in various territories and to identify the role of computed tomography angiography (CTA), both in diagnosis and follow-up.

MATERIALS AND METHODS

The study included 19 patients (11 male, 8 female) aged between 24 and 85 years. In all, 24 stent-grafts were used to seal an extravasation in 3 patients, a pseudoaneurysm/aneurysm in 12 patients, and an arteriovenous fistula in 4 patients. Self-expandable and balloon-expandable stent-grafts were used, all of which were covered with polytetrafluoroethylene material. Iatrogenic etiologies were responsible in 11 of the patients. In total, 5 superficial femoral, 2 deep femoral, 4 external iliac, 3 common iliac, 1 common carotid, 1 internal carotid, 1 subclavian, 1 renal artery, and 1 thyrocervical trunk lesion were treated.

RESULTS

The technical success rate was 100%, with no periprocedural complications. Mean follow-up was 18 months (range: 1-72 months). CTA was performed in 10 patients for diagnosis and in 7 patients for follow- up. There was no stent migration, but 1 stent crush. The total vessel occlusion rate was 16.6%, all diagnosed using CTA.

CONCLUSION

Stent-graft applications offer quick, single-step treatment, with few procedural complications. However, long-term durability remains a major concern. CTA is a very valuable tool, both for diagnosis and follow- up. Pseudoaneurysms and extravasations can be demonstrated successfully, as well as incomplete arteriovenous fistula closure, and patent or occluded stent-grafts.

摘要

目的

回顾性评估在不同部位使用覆膜支架治疗的外周动脉病变,并确定计算机断层血管造影(CTA)在诊断和随访中的作用。

材料与方法

本研究纳入了19例患者(11例男性,8例女性),年龄在24至85岁之间。总共使用24个覆膜支架封堵3例患者的血管外渗、12例患者的假性动脉瘤/动脉瘤以及4例患者的动静脉瘘。使用了自膨式和球囊扩张式覆膜支架,所有支架均覆盖聚四氟乙烯材料。11例患者病因是医源性的。共治疗了5例股浅动脉、2例股深动脉、4例髂外动脉、3例髂总动脉、1例颈总动脉、1例颈内动脉、1例锁骨下动脉、1例肾动脉和1例甲状颈干病变。

结果

技术成功率为100%,无围手术期并发症。平均随访时间为18个月(范围:1至72个月)。10例患者进行CTA用于诊断,7例患者进行CTA用于随访。没有支架移位,但有1例支架受压。总血管闭塞率为16.6%,均通过CTA诊断。

结论

覆膜支架应用提供了快速的单步治疗,手术并发症少。然而,长期耐久性仍是一个主要问题。CTA对于诊断和随访都是非常有价值的工具。假性动脉瘤和血管外渗以及动静脉瘘闭合不全、覆膜支架通畅或闭塞均可成功显示。

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