Endovascular stent-grafting through the aortic arch: an alternative approach for distal arch aortic aneurysm.
Endovascular stent-grafting through the aortic arch: an alternative approach for distal arch aortic aneurysm.
复制标题
通过主动脉弓血管内支架移植：远端主动脉弓动脉瘤的另一种方法。
DOI：
10.1016/s0003-4975(00)01927-5
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发表时间：
2000
期刊：
影响因子：
--
通讯作者：
Y. Matsuura
中科院分区：
文献类型：
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作者：
T. Sueda;M. Watari;K. Okada;K. Orihashi;Y. Matsuura
背景：血管支架植入术是一项创新的手术；我们已经开发了一种通过主动脉弓小切口治疗远端主动脉弓动脉瘤的新方法。方法采用经主动脉弓小切口置入胸主动脉的血管内支架治疗8例胸主动脉瘤。其中7例为远端弓主动脉瘤，1例为Stanford b型慢性主动脉夹层。其中4例合并行冠状动脉旁路移植术，1例行三尖瓣瓣膜成形术。在选择性脑灌注和低温停循环的条件下，通过主动脉弓小切口将支架植入远动脉弓和降主动脉。结果选择性脑灌注时间52 ~ 86分钟，平均68分钟；手术时间289 ~ 422分钟，平均318分钟。动脉瘤内未见腔内渗漏。7例患者存活出院，1例患者在随访期间发生脑梗死死亡。结论经主动脉弓置入血管内支架是治疗远端主动脉弓动脉瘤的一种可接受的方法。
BackgroundEndovascular stent-grafting is an innovative procedure; we have developed a novel approach to treat distal arch aortic aneurysm through a small incision in the aortic arch.MethodsEight patients with thoracic aortic aneurysms were treated with an endovascular stent-graft that was introduced into the thoracic aorta through a small incision in the aortic arch. Of these patients, 7 had distal arch aortic aneurysms, and 1 had chronic aortic dissection of Stanford type B. Four of these patients had received concomitant coronary artery bypass grafting, and 1 patient had undergone tricuspid valvular annuloplasty. The stent-graft was introduced into the distal arch aorta and descending aorta through a small incision in the aortic arch, under selective cerebral perfusion and hypothermic circulatory arrest.ResultsThe selective cerebral perfusion time ranged from 52 to 86 minutes (mean, 68 minutes) and the operating time from 289 to 422 minutes (mean, 318 minutes). There was no endoluminal leakage into the aneurysm. Seven patients survived and were discharged, but 1 patient suffered a cerebral infarction and died during the follow-up period.ConclusionsPlacing an endovascular stent-graft through the aortic arch is an acceptable alternative treatment for distal arch aortic aneurysms.