Graves Holly L, Jackson Benjamin M
Division of Vascular Surgery and Endovascular Therapy, Department of General Surgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania.
Semin Intervent Radiol. 2015 Sep;32(3):304-10. doi: 10.1055/s-0035-1558707.
Endovascular abdominal aortic aneurysm repair (EVAR) provides an attractive alternative to traditional open techniques. Endovascular repair is frequently limited by aortic aneurysm neck angulation, the absence of an adequate infrarenal neck, and the need for internal iliac preservation. Several devices have been created to incorporate visceral artery segments as well as preserve the internal iliac artery, thus broadening the patient population suited for endovascular repair. This article will provide a review of the current literature regarding fenestrated devices, branch devices, off-the-shelf devices, and physician-modified devices. It will also highlight the iliac branch stent grafts currently on trial for internal iliac artery preservation. Data thus far have suggested that these devices will be both a safe and effective option for anatomically challenging abdominal aortic aneurysms.
血管腔内腹主动脉瘤修复术（EVAR）为传统开放技术提供了一种有吸引力的替代方案。血管腔内修复术常常受到腹主动脉瘤颈部成角、缺乏足够的肾下颈部以及需要保留髂内动脉的限制。已经研发出了几种装置，用于纳入内脏动脉段以及保留髂内动脉，从而扩大了适合血管腔内修复的患者群体。本文将对有关开窗装置、分支装置、现成装置和医生改良装置的当前文献进行综述。它还将重点介绍目前正在进行保留髂内动脉试验的髂支型覆膜支架。迄今为止的数据表明，这些装置对于解剖结构复杂的腹主动脉瘤将是一种安全有效的选择。
