Riambau Vincent
Vascular Surgery Division, Thorax Institute, Hospital Clinic of Barcelona, Barcelona, Spain.
Aorta (Stamford). 2015 Feb 1;3(1):16-24. doi: 10.12945/j.aorta.2015.14-050. eCollection 2015 Feb.
Endovascular correction of aortic arch pathology remains a challenge, with a variety of techniques proposed over the years to minimize complications and enhance the probability of a successful result. A variety of approaches have been developed in order to deal with the aortic arch pathology and its idiosyncrasies. We review potential interventional techniques for the repair of aortic arch pathologies, beginning with conventional aortic arch surgery, followed by hybrid treatments and those along the endovascular spectrum (parallel and fenestrated endografts, scalloped endografts, and ascending and new branched endografts). We finish with an overview of all the Bolton Medical (Barcelona, Spain and Sunrise, FL, USA) thoracic platforms. Endovascular techniques show acceptable results in selected cases. Both proximal Bolton Relay configurations (with and without a bare stent) offer conformability and accuracy on deployment with very low rates of stroke. Fenestrated and scalloped designs are also useful for selected cases. Ascending and branched Bolton devices are very promising platforms for a serious, full endovascular approach to the aorta.
主动脉弓病变的血管内矫正仍然是一项挑战,多年来人们提出了各种技术来尽量减少并发症并提高成功的概率。为了应对主动脉弓病变及其特殊情况,已经开发了多种方法。我们回顾了修复主动脉弓病变的潜在介入技术,首先是传统的主动脉弓手术,然后是杂交治疗以及血管内领域的技术(平行和开窗型血管内移植物、扇形血管内移植物以及升主动脉和新型分支血管内移植物)。最后我们概述了所有博尔顿医疗公司(西班牙巴塞罗那和美国佛罗里达州日出市)的胸段平台。血管内技术在特定病例中显示出可接受的结果。近端博尔顿中继配置(带和不带裸支架)在部署时都具有顺应性和准确性,中风发生率极低。开窗和扇形设计对特定病例也很有用。升主动脉和分支型博尔顿装置是采用全面的血管内方法治疗主动脉的非常有前景的平台。