Soga Yoshimitsu, Nakata Marohito, Ando Kenji
Kokura Memorial Hospital, Department of Cardiology, Kitakyushu, Japan.
Naha City Hospital, Department of Cardiology, Naha, Japan.
J Cardiol Cases. 2020 Jun 16;22(3):143-146. doi: 10.1016/j.jccase.2020.05.024. eCollection 2020 Sep.
Appropriate endovascular treatment for aortic bifurcation lesions remains unclear. Incomplete apposition and radial mismatch have not been resolved to date. We treated two cases of aortic bifurcation lesions including common iliac aneurysms with balloon-expandable covered stents with "Double-D molding technique (DDMT)." This is the method. First, standard kissing stent technique with two balloon-expandable covered stents for aortic bifurcation lesions is performed. Second, either covered stent post-dilated with a larger size percutaneous transluminal angioplasty (PTA) balloon before the other covered stent also post-dilated with the same larger size PTA balloon. Kissing balloon technique was performed with the two previous size PTA balloons. Good double-D shape configuration is observed. This DDMT could improve the radial mismatch of the kissing covered stents to distal aortic wall. 〈 The treatment of aortoiliaic bifurcation disease including iliac aneurysms with balloon expandable covered stents using "double D-shape molding technique" is safe and effective.〉.
对于主动脉分叉病变，合适的血管内治疗方法仍不明确。内膜贴壁不全和径向不匹配问题至今尚未得到解决。我们使用“双D成型技术（DDMT）”，用球囊扩张型覆膜支架治疗了两例主动脉分叉病变，包括髂总动脉瘤。方法如下：首先，对主动脉分叉病变采用两个球囊扩张型覆膜支架进行标准的吻合法支架技术操作。其次，在另一个覆膜支架也用相同较大尺寸的经皮腔内血管成形术（PTA）球囊进行后扩张之前，先用较大尺寸的PTA球囊对其中一个覆膜支架进行后扩张。然后用之前尺寸的两个PTA球囊进行吻合法球囊技术操作。观察到良好的双D形构型。这种双D成型技术可以改善吻合法覆膜支架与远端主动脉壁之间的径向不匹配。〈 使用“双D形成型技术”，用球囊扩张型覆膜支架治疗包括髂动脉瘤在内的主髂动脉分叉疾病是安全有效的。〉
