Chuter T A, Wendt G, Hopkinson B R, Scott R A, Risberg B, Walker P J, White G
Department of Surgery, Columbia University College of Physicians and Surgeons, New York, NY 10032, USA.
Cardiovasc Surg. 1995 Apr;3(2):121-8. doi: 10.1016/0967-2109(95)90884-8.
The purpose of this study was to evaluate and optimize a system of transfemoral bifurcated graft insertion for endovascular repair of infrarenal aortic aneurysm. Grafts were inserted through bilateral femoral arteriotomies in 22 patients. Placement was guided by fluoroscopy. Results were assessed by completion angiography, with computed tomography scanning or duplex ultrasonography at 1, 3 and 6 months. The first 11 insertions were complicated by failed insertion in two cases, proximal leakage in one, graft limb thrombosis in five and wound infection in one. The second 11 insertions were complicated by retrograde leakage around the distal graft orifice in two patients. One of these was associated with aneurysm rupture, leading to the sole mortality of the series. There were no instances of graft migration or embolism. In conclusion, the lessons learned during the first 11 insertions were responsible for the improved results apparent in the second 11 insertions. When applied in properly selected patients, transfemoral insertion of a bifurcated graft is a reliable method of isolating an aortic aneurysm from the circulation.
本研究的目的是评估和优化用于肾下腹主动脉瘤血管腔内修复的经股动脉分叉移植物植入系统。对22例患者通过双侧股动脉切开术植入移植物。在荧光透视引导下进行放置。通过完成血管造影评估结果，并在1、3和6个月时进行计算机断层扫描或双功超声检查。最初的11例植入出现了以下并发症：2例植入失败、1例近端渗漏、5例移植物肢体血栓形成和1例伤口感染。后11例植入有2例患者出现移植物远端孔口周围逆行渗漏。其中1例与动脉瘤破裂相关，导致该系列唯一的死亡病例。没有移植物迁移或栓塞的情况。总之，在前11例植入过程中吸取的经验教训是后11例植入结果明显改善的原因。当应用于适当选择的患者时，经股动脉植入分叉移植物是将主动脉瘤与循环系统隔离的可靠方法。
