Wang Mian, He Qiong, Yao Chen, Yin Heng-Hui, Wang Shen-Ming, Chang Guang-Qi
Division of Vascular Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, People's Republic of China.
Division of Pathology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, People's Republic of China.
Ann Vasc Surg. 2020 Feb;63:108-116. doi: 10.1016/j.avsg.2019.06.041. Epub 2019 Sep 16.
This study aims to present the performance data on stent-graft and multilayer bare stents (MBS) joint technique in the treatment of high-risk thoracoabdominal aortic aneurysm (TAAA).
From May 2012 to December 2015, 8 selective TAAA cases (ages 46-75 years) ineligible for surgical repair underwent the stent-graft and MBS joint procedure, and were closely followed up for a median of 32 months (range 14-58). Using computed tomography images, the aneurysm size, luminal blood flow diameter, and the covered visceral branches were analyzed.
Technical success was achieved in all patients (100%, 8/8). Twenty-four visceral branches were covered by MBS in total. There was no complication or death during hospital stay. During follow-up period, no death or complication occurred. Aneurysm shrinkage (maximum diameter decrease ≥5 mm) was observed in 7 patients. No aneurysm expansion was observed. Total aneurysm sac thrombosis was observed in all patients. The majority of covered side branches (23/24) were successfully preserved. No visceral ischemia or bleeding complications was observed during follow-up.
Total endovascular repair of TAAA using stent-graft and MBS joint technique may be a safe and effective alternative in high surgical risk patients. More approving clinical evidences about the safety and efficacy of this procedure are anticipated.
本研究旨在展示支架型人工血管与多层裸支架(MBS)联合技术治疗高危胸腹主动脉瘤(TAAA)的性能数据。
2012年5月至2015年12月,8例不适合手术修复的选择性TAAA患者(年龄46 - 75岁)接受了支架型人工血管与MBS联合手术,并进行了中位时间为32个月(范围14 - 58个月)的密切随访。利用计算机断层扫描图像分析动脉瘤大小、管腔血流直径以及被覆盖的内脏分支。
所有患者均获得技术成功(100%,8/8)。MBS共覆盖24个内脏分支。住院期间无并发症或死亡发生。随访期间,无死亡或并发症发生。7例患者观察到动脉瘤缩小(最大直径减小≥5 mm)。未观察到动脉瘤扩张。所有患者均观察到动脉瘤囊完全血栓形成。大多数被覆盖的侧支(23/24)得以成功保留。随访期间未观察到内脏缺血或出血并发症。
使用支架型人工血管与MBS联合技术对TAAA进行全腔内修复可能是高手术风险患者的一种安全有效的替代方法。期待更多关于该手术安全性和有效性的认可性临床证据。