Yazar Ozan, Budts Werner, Maleux Geert, Houthoofd Sabrina, Daenens Kim, Fourneau Inge
Department of Vascular Surgery, University Hospitals Leuven, Leuven, Belgium.
Ann Vasc Surg. 2011 Nov;25(8):1005-11. doi: 10.1016/j.avsg.2011.05.031.
To report our experience with thoracic endovascular aortic repair (TEVAR) for treatment of postcoarctation repair aortic aneurysms.
Between November 2000 and December 2008, 13 patients were treated with TEVAR and rerouting of the supra-aortic vessels for aortic aneurysm (n = 10) and pseudoaneurysm (n = 3).
One patient (7.7%) died due to peroperative perforation of the aorta. For the other patients, the median hospital stay was 9 days. One patient needed an additional stent because of a type I endoleak. Two patients (15.4%) developed a small type II endoleak for which no additional intervention was needed. One patient developed hemothorax, four patients (30.8%) had a Horner syndrome, one patient had a phrenic nerve paresis, and another patient developed hemiplegia. The mean follow-up of the survivors was 35 months (range, 2-72) with a median of 30 months. Most patients (84.6%) showed a decrease or stabilization of the size of the aneurysm sac. One patient had recurrent pneumonia with increase of the size aneurysm after 3 years.
TEVAR is appealing for patients with late complications after aortic coarctation repair, but necessitates long-term follow-up.
报告我们采用胸主动脉腔内修复术(TEVAR)治疗动脉导管未闭修复术后主动脉瘤的经验。
2000年11月至2008年12月期间,13例患者接受了TEVAR治疗,并对主动脉瘤(n = 10)和假性动脉瘤(n = 3)进行了主动脉弓上血管改道。
1例患者(7.7%)因手术中主动脉穿孔死亡。其他患者的中位住院时间为9天。1例患者因I型内漏需要额外放置支架。2例患者(15.4%)出现小的II型内漏,无需额外干预。1例患者发生血胸,4例患者(30.8%)出现霍纳综合征,1例患者出现膈神经麻痹,另1例患者出现偏瘫。幸存者的平均随访时间为35个月(范围2 - 72个月),中位随访时间为30个月。大多数患者(84.6%)的动脉瘤囊大小减小或稳定。1例患者在3年后出现复发性肺炎,动脉瘤大小增大。
TEVAR对动脉导管未闭修复术后晚期并发症患者具有吸引力,但需要长期随访。