Oderich Gustavo S, Mendes Bernardo C, Kanamori Karina S
1Mayo Clinic, Rochester, MN, USA.
Perspect Vasc Surg Endovasc Ther. 2013 Jun;25(1-2):28-37. doi: 10.1177/1531003513512372.
Endovascular repair of complex aneurysms involving the visceral arteries has become a reality. Fenestrated endovascular aortic repair (FEVAR) has been used with increasing frequency to treat complex aortic aneurysms. The Zenith fenestrated stent-graft system (Cook Medical Inc, Brisbane, Australia) was approved for commercial use in the United States in April 2012, offering a custom-made design with up to 3 fenestrations to treat short-neck infrarenal and juxtarenal abdominal aortic aneurysms. Nevertheless, FEVAR is a complex procedure that demands accurate planning, advanced endovascular skills, and excellent perioperative patient care to achieve optimal outcomes. This article summarizes the basic concepts of device design, case planning, techniques of implantation, and some of the "bail-out" maneuvers that may be required during endovascular repair using the Zenith fenestrated stent-graft system.
涉及内脏动脉的复杂动脉瘤的血管内修复已成为现实。开窗式血管内主动脉修复术（FEVAR）治疗复杂主动脉瘤的应用频率越来越高。Zenith开窗支架移植物系统（库克医疗公司，澳大利亚布里斯班）于2012年4月在美国获批商业使用，提供定制设计，最多有3个开窗，用于治疗短颈肾下和近肾腹主动脉瘤。然而，FEVAR是一个复杂的手术，需要精确的规划、先进的血管内技术以及出色的围手术期患者护理，以实现最佳治疗效果。本文总结了使用Zenith开窗支架移植物系统进行血管内修复时的器械设计、病例规划、植入技术以及一些可能需要的“补救”操作的基本概念。
