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应用Amplatzer封堵器经皮闭合主动脉假性动脉瘤——6例患者的病例系列报道

Percutaneous closure of aortic pseudoaneurysm by Amplatzer occluder device-case series of six patients.

作者信息

Hussain Jamal, Strumpf Robert, Wheatley Grayson, Diethrich Edward

机构信息

Cardiac Catheterization Laboratories, Arizona Heart Hospital, Arizona Heart Institute, Phoenix, Arizona 85006, USA.

出版信息

Catheter Cardiovasc Interv. 2009 Mar 1;73(4):521-9. doi: 10.1002/ccd.21833.

Abstract

Thoracic pseudoaneurysms are rare variety of aortic disorders. Although mostly asymptomatic, they represent potentially fatal conditions (Sullivan et al., Chest 1988;93:138-143; Razzouk et al., Ann Surg 1993;59:818-823) that are traditionally treated surgically. False aneurysms of aorta are usually a late complication of previous surgical procedure (Sullivan et al., 1988)-especially reconstructive surgery, trauma (Razzouk et al., 1993), and rarely infection (Sanchez-Recalde et al., J Am Coll Cardiol 2003;41:152-154). Surgical management is often complicated by poor outcomes with high morbidity and mortality (Mulder et al., Arch Surg 1998;133:45-49). Endovascular treatment is emerging as promising options for aortic diseases with fewer complications. We report a series of six cases at a single center where Amplatzer device was used to treat thoracic aortic pseudo aneurysm. To our knowledge only one series of three cases (Kanani et al., Catheter Cardiovasc Interv 2007;69:146-153) and few case reports (Bashi et al., Catheter Cardiovasc Interv 2005;65:547-551) of successful closure have been published previously. Our case series is the largest, so far, including mortality and specifically the preprocedural and postprocedural CT angiographic assessment of the pseudoaneurysms.

摘要

胸段假性动脉瘤是一种罕见的主动脉疾病。虽然大多无症状,但它们是潜在的致命疾病(沙利文等人,《胸部》1988年;93:138 - 143;拉祖克等人,《外科学年鉴》1993年;59:818 - 823),传统上采用手术治疗。主动脉假性动脉瘤通常是先前手术操作的晚期并发症(沙利文等人,1988年)——尤其是重建手术、创伤(拉祖克等人,1993年),很少是感染(桑切斯 - 雷卡尔德等人,《美国心脏病学会杂志》2003年;41:152 - 154)。手术治疗常常因高发病率和死亡率导致的不良结局而复杂化(穆德等人,《外科学文献》1998年;133:45 - 49)。血管内治疗正成为并发症较少的主动脉疾病的有前景的选择。我们报告了在单一中心使用Amplatzer装置治疗胸主动脉假性动脉瘤的一系列6例病例。据我们所知,此前仅发表过一组3例成功封堵的病例系列(卡纳尼等人,《心血管介入导管治疗》2007年;69:146 - 153)以及少数病例报告(巴希等人,《心血管介入导管治疗》2005年;65:547 - 551)。我们的病例系列是迄今为止最大的,包括死亡率以及对假性动脉瘤术前和术后CT血管造影的评估。

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