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使用致密网孔支架结合释放及后处理技术对残余主动脉夹层进行一期修复的初步结果。

Preliminary results of one-stage repair of residual aortic dissection using dense mesh stent combined with release and post-processing techniques.

作者信息

Li Shouming, Qiao Huanyu, Zhang Chen, Bai Tao, Yang Bo, Zhao Honglei, Zhang Kefeng, Cheng Zhang, Zhang Hongbo, Ma Xiaohai, Liu Yongmin

机构信息

Department of Cardiovascular Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.

Department of Interventional Diagnosis and Treatment, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.

出版信息

Sci Prog. 2025 Apr-Jun;108(2):368504251340800. doi: 10.1177/00368504251340800. Epub 2025 Jun 5.

Abstract

ObjectiveThis study aims to preliminarily evaluate the early safety and efficacy of one-stage repair of residual aortic dissection using dense metal mesh stents combined with improved release and post-processing techniques.MethodsA prospective, single-center, single-arm clinical trial was designed and implemented, enrolling patients with residual aortic dissection to undergo metal mesh stent implantation under guidance of stent release and post-processing techniques. Patients received aortic CTA follow-up at 30 days post-surgery to assess early safety and efficacy.ResultsA total of 25 patients were enrolled, 14 in the (sub)acute phase and 11 in the chronic phase. No postoperative deaths, reinterventions, or aortic-related adverse events like malperfusion or ischemia were reported. The immediate technical success rate was 100%. For (sub)acute cases, the true lumen volume increased by 176.10%, while the false lumen decreased by 83.95%. False lumen thrombosis was grade II in two patients (14.29%), grade III in seven (50.00%), and grade IV in five (35.71%). For chronic cases, the true lumen volume increased by 96.92%, while the false lumen decreased by 73.43%. Thrombosis was grade II in three patients (27.27%), grade III in five (45.45%), and grade IV in three (27.27%). Postoperative aortic CTA showed that all visceral artery branches remained patent, and high-risk ischemic branches were converted to non-high-risk.ConclusionsPreliminary results suggest that dense mesh stents combined with release and post-processing techniques have acceptable early safety and efficacy. For acute and chronic residual aortic dissection patients with visceral artery branch involvement, this method may offer an alternative treatment option. Registration no. ChiCTR2200055277.

摘要

目的

本研究旨在初步评估采用致密金属网支架结合改进的释放及后处理技术对残留主动脉夹层进行一期修复的早期安全性和有效性。

方法

设计并实施一项前瞻性、单中心、单臂临床试验,纳入残留主动脉夹层患者,在支架释放及后处理技术的引导下进行金属网支架植入。患者在术后30天接受主动脉CTA随访,以评估早期安全性和有效性。

结果

共纳入25例患者,其中14例处于(亚)急性期,11例处于慢性期。未报告术后死亡、再次干预或主动脉相关不良事件,如灌注不良或缺血。即刻技术成功率为100%。对于(亚)急性病例,真腔容积增加176.10%,假腔减少83.95%。2例患者(14.29%)假腔血栓形成分级为II级,7例(50.00%)为III级,5例(35.71%)为IV级。对于慢性病例,真腔容积增加96.92%,假腔减少73.43%。3例患者(27.27%)血栓形成分级为II级,5例(45.45%)为III级,3例(27.27%)为IV级。术后主动脉CTA显示所有内脏动脉分支均保持通畅,高危缺血分支转变为非高危。

结论

初步结果表明,致密网支架结合释放及后处理技术具有可接受的早期安全性和有效性。对于累及内脏动脉分支的急慢性残留主动脉夹层患者,该方法可能提供一种替代治疗选择。注册号:ChiCTR2200055277。

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