Arko Frank R, Murphy Erin H
University of Texas Southwestern Medical Center, Dallas, Texas 75390-9157, USA.
Perspect Vasc Surg Endovasc Ther. 2008 Jun;20(2):120-8; discussion 129-35. doi: 10.1177/1531003508320226.
Favorable clinical results combined with increased patient demand for minimally invasive surgery have resulted in an increased application of endovascular aneurysm repair, and this treatment modality is now being extended to younger, healthier patients. While it seems that endovascular aneurysm repair is becoming a desirable option for many patients, it is essential to realize that the feasibility of the procedure may be limited at times by patient anatomy and technical difficulties. Specific anatomical difficulties can be imposed by difficult access, short, tortuous and calcified aortic and iliac landing zones, and the presence of coincident complex iliac aneurysms. This manuscript will discuss the use of 2 approved devices from a single manufacturer (Medtronic, Santa Rosa, Calif) and their clinical results in the treatment of infrarenal abdominal aortic aneurysms. We will discuss technical maneuvers and considerations when encountering difficult anatomical situations and how to avoid long-term complications.
良好的临床效果以及患者对微创手术需求的增加，导致血管内动脉瘤修复术的应用增多，并且这种治疗方式目前正在扩展到更年轻、更健康的患者。虽然血管内动脉瘤修复术似乎正成为许多患者理想的选择，但必须认识到，该手术的可行性有时可能会受到患者解剖结构和技术难题的限制。具体的解剖难题可能由入路困难、主动脉和髂动脉着陆区短、迂曲且钙化，以及合并复杂髂动脉瘤的存在所导致。本文将讨论来自单一制造商（美敦力公司，加利福尼亚州圣罗莎市）的两种获批器械的使用及其在治疗肾下腹主动脉瘤方面的临床效果。我们将讨论在遇到困难解剖情况时的技术操作和注意事项，以及如何避免长期并发症。
