安库拉胸主动脉覆膜支架在主动脉弓病变伴头臂干开放及血管腔内灌注中的围手术期及中期结果：一项回顾性研究
Perioperative and Mid-term Outcomes of the Ankura Thoracic Stent Graft in Aortic Arch Pathologies With Open and Endovascular Perfusion of Supra-Aortic Branches: A Retrospective Review.
作者信息
Tigkiropoulos Konstantinos, Chatziantoniou Georgios, Sidiropoulou Katerina, Apostolou Alexandros, Stavridis Kyriakos, Chatzelas Dimitrios A, Karamanos Dimitrios, Pitoulias Georgios, Saratzis Nikolaos
机构信息
Division of Vascular Surgery, 1st Surgical Department, School of Medicine, Aristotle University of Thessaloniki, Papageorgiou General Hospital, Thessaloniki, GRC.
Division of Vascular Surgery, 2nd Department of Surgery, School of Health Sciences, Aristotle University of Thessaloniki, General Hospital of Thessaloniki "G. Gennimatas", Thessaloniki, GRC.
出版信息
Cureus. 2025 Jul 23;17(7):e88594. doi: 10.7759/cureus.88594. eCollection 2025 Jul.
BACKGROUND AND AIMS
This study reports on the perioperative and mid-term outcomes of a novel thoracic stent graft in aortic arch pathologies.
METHODS
From January 2017 to May 2023, all patients treated with Ankura (Lifetech Scientific, Shenzhen, China) thoracic endograft combined with extra-anatomic and/or endovascular perfusion of supra-aortic branches at two university vascular centers were retrospectively reviewed. Indications for treatment included aneurysm, dissection, penetrating ulcer, intramural hematoma, traumatic rupture of the aortic arch and endoleak type Ia (Ia EL) of previous endovascular repair of the descending thoracic aorta. Perioperative and late causes of morbidity and mortality were captured. Patients' follow-up was obtained by computed tomography angiography at one month, six months, one year and then annually. The primary endpoint of the study was technical success, and secondary endpoints included aortic-related complications and all-cause mortality during follow-up.
RESULTS
Aortic arch repair with Ankura thoracic endograft was performed in 30 patients. Mean age was 69.3 years (53-85 years), and male was the prevalent gender (25 patients, 83%). According to Ishimaru classification, Ankura stent graft was deployed at zone 2 in 21 patients (70%), at zone 1 in eight patients (26.6%) and at zone 0 in one patient (3.3%). Technical success was 94%. Type Ia EL was detected at two patients (6.6%). Perioperative morbidity and mortality were 6.6% and 3.3%, respectively. Mean follow-up was 22.03 months (range: 1-24 months). The aortic reintervention rate was 0%, and all-cause mortality was 16.6%.
CONCLUSION
Ankura thoracic endograft showed satisfactory results with high technical success and low aortic-related complications in our study. Larger studies are necessary to establish the safety and efficacy of Ankura endograft in aortic arch pathologies.
背景与目的
本研究报告一种新型胸主动脉覆膜支架在主动脉弓病变中的围手术期及中期结果。
方法
回顾性分析2017年1月至2023年5月期间，在两家大学血管中心接受安库拉（深圳微创医疗科学有限公司）胸主动脉覆膜支架联合主动脉弓上分支体外解剖和/或血管内灌注治疗的所有患者。治疗适应证包括动脉瘤、夹层、穿透性溃疡、壁内血肿、主动脉弓创伤性破裂以及降主动脉先前血管内修复术后的Ⅰa型内漏（Ia EL）。记录围手术期及晚期发病和死亡原因。通过计算机断层扫描血管造影在术后1个月、6个月、1年及之后每年对患者进行随访。本研究的主要终点是技术成功，次要终点包括随访期间与主动脉相关的并发症和全因死亡率。
结果
30例患者接受了安库拉胸主动脉覆膜支架修复主动脉弓手术。平均年龄为69.3岁（53 - 85岁），男性居多（25例，83%）。根据石丸分类，21例患者（70%）的安库拉覆膜支架置于2区，8例患者（26.6%）置于1区，1例患者（3.3%）置于0区。技术成功率为94%。2例患者（6.6%）检测到Ia EL。围手术期发病率和死亡率分别为6.6%和3.3%。平均随访时间为22.03个月（范围：1 - 24个月）。主动脉再次干预率为0%，全因死亡率为16.6%。
结论
在我们的研究中，安库拉胸主动脉覆膜支架显示出令人满意的结果，技术成功率高且与主动脉相关的并发症低。需要开展更大规模的研究以确定安库拉覆膜支架在主动脉弓病变中的安全性和有效性。
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