Kim Kyung Yun, Byun Seung Jae, Yun Kyeong Ho, Lee Sam Youn, Ryu Dae Woong, Rhee Sang Jae, So Byung Jun
Department of Vascular Surgery, Wonkwang University School of Medicine & Hospital, Iksan, Korea.
J Korean Surg Soc. 2012 May;82(5):302-5. doi: 10.4174/jkss.2012.82.5.302. Epub 2012 Apr 26.
The purpose of this retrospective study was to evaluate the short- to mid-term results of thoracic endovascular aortic repair (TEVAR) in Wonkwang University School of Medicine & Hospital.
Between February 2009 and May 2011, 8 consecutive patients had undergone endovascular stent-grafting for thoracic aortic diseases. Five patients were treated for traumatic thoracic aortic injuries, two patients were treated for thoracic aneurysms and one patient was treated for a pseudoaneurysm due to penetrating aortic ulcers. Attempted stent-graft deployment was performed electively in 6 patients and emergently in 2. Follow-up was performed at 1-month, 6-month, 1-year, and annually thereafter.
Technical success rates were achieved in 87.5% and the 30-day mortality rate was 0%. Mean hospital length of stay after TEVAR was 30 days in traumatic thoracic aortic injuries and 10 days in thoracic aneurismal diseases. Intra-operative Type I endoleak due to migration at deflation was visualized in 1 patient, which was treated by insertion of another stent-graft. During follow-up, a major complication was encountered in one patient who received carotid-subclavian bypass to relieve left arm ischemia. After 5 months he was treated with arch replacement for aortic arch aneurysm with type I endoleak at proximal site after endovascular treatment. The 30-day mortality rate was 0%. However, 1 case of mortality (12.5%) was observed during the follow-up period.
The short and mid-term results of endovascular repair of thoracic aortic diseases are promising. TEVAR is an effective procedure in the management of thoracic aortic diseases.
本回顾性研究旨在评估圆光大学医学院及附属医院胸主动脉腔内修复术(TEVAR)的短期至中期结果。
2009年2月至2011年5月,连续8例患者接受了胸主动脉疾病的血管内支架植入术。5例患者因创伤性胸主动脉损伤接受治疗,2例患者因胸主动脉瘤接受治疗,1例患者因穿透性主动脉溃疡导致的假性动脉瘤接受治疗。6例患者择期进行支架植入,2例患者急诊进行。术后1个月、6个月、1年及此后每年进行随访。
技术成功率为87.5%,30天死亡率为0%。TEVAR术后,创伤性胸主动脉损伤患者的平均住院时间为30天,胸主动脉瘤疾病患者为10天。1例患者术中出现因放气时移位导致的I型内漏,通过植入另一个支架进行治疗。随访期间,1例接受颈动脉-锁骨下动脉旁路移植术以缓解左臂缺血的患者出现了严重并发症。5个月后,他因血管内治疗后近端部位出现I型内漏的主动脉弓动脉瘤接受了主动脉弓置换术。30天死亡率为0%。然而,随访期间观察到1例死亡(12.5%)。
胸主动脉疾病血管内修复的短期和中期结果令人满意。TEVAR是治疗胸主动脉疾病的有效方法。