Funovics Martin, Blum Melanie, Langenberger Herbert, Plank Christina, Schoder Maria, Edelhauser Gundula, Gottardi Roman, Berzacky Dominik, Dorfmeister Marion, Grimm Michael, Lammer Johannes, Czerny Martin
Cardiovascular and Interventional Radiology, Medical University of Vienna, Vienna, Austria.
Ann Thorac Surg. 2009 Aug;88(2):637-40. doi: 10.1016/j.athoracsur.2008.12.078.
The aim of this study was to evaluate the efficacy and safety of thoracic endovascular aortic repair with a newly designed Relay thoracic stent graft (Bolton Medical, Sunrise, FL).
Between 2005 and 2007, 22 patients (71.8 +/- 8.5) received 24 stent grafts. Indications were aneurysms (n = 13), penetrating atherosclerotic ulcers (n = 7), and dissections (n = 2). Due to the proximity of the lesions to the aortic arch, rerouting procedures (ie, subclavian transposition [n = 1], double transposition [n = 12], and total arch rerouting [n = 6] were performed pre-interventionally; three patients did not undergo rerouting). All patients were followed-up with a computed tomographic scan of the entire aorta at discharge, 3 months, 6 months, and annually thereafter (mean follow-up, 13 months).
Primary technical success was obtained in 20 of 22 patients, with one persisting type I endoleak and one asymptomatic type II endoleak. One patient died due to malignant arrhythmia 3 days after stent-graft placement. During follow-up, 1 nonaortic related death was observed. No additional endoleaks were observed. Finally, all supra-aortic rerouting procedures remained patent.
In the treatment of degenerative disease of the descending aorta and the aortic arch, the Bolton Relay stent graft offers acceptable efficacy and safety in short-term follow-up.
本研究旨在评估使用新设计的Relay胸主动脉覆膜支架(博尔顿医疗公司,佛罗里达州日出市)进行胸主动脉腔内修复术的疗效和安全性。
2005年至2007年期间,22例患者(年龄71.8±8.5岁)接受了24枚覆膜支架。适应证包括动脉瘤(n = 13)、穿透性动脉粥样硬化溃疡(n = 7)和夹层(n = 2)。由于病变靠近主动脉弓,干预前进行了改道手术(即锁骨下动脉转位术[n = 1]、双转位术[n = 12]和全弓改道术[n = 6]);3例患者未进行改道。所有患者在出院时、3个月、6个月以及此后每年均接受全主动脉计算机断层扫描随访(平均随访13个月)。
22例患者中有20例取得了主要技术成功,1例存在持续性I型内漏,1例为无症状II型内漏。1例患者在覆膜支架置入后3天因恶性心律失常死亡。随访期间,观察到1例非主动脉相关死亡。未观察到额外的内漏。最后,所有主动脉弓上改道手术均保持通畅。
在降主动脉和主动脉弓退行性疾病的治疗中,博尔顿Relay覆膜支架在短期随访中提供了可接受的疗效和安全性。