In situ diode laser fenestration of aortic arch stent grafts during thoracic endovascular aortic repair of Stanford type A aortic dissection
In situ diode laser fenestration of aortic arch stent grafts during thoracic endovascular aortic repair of Stanford type A aortic dissection
复制标题
斯坦福 A 型主动脉夹层胸主动脉腔内修复术中主动脉弓覆膜支架原位二极管激光开窗术
DOI：
10.4244/eij-d-18-00710
复制
发表时间：
2019-04-01
期刊：
影响因子：
6.2
通讯作者：
Lu, Xinwu
中科院分区：
文献类型：
--
作者：
Qin, Jinbao;Zhao, Zhen;Lu, Xinwu
目的：本研究旨在评价胸主动脉腔内修复术（TEVAR）覆膜支架原位半导体激光开窗术治疗斯坦福大学A型主动脉夹层的可行性、安全性和有效性。方法和结果：五十-回顾了8例急性或亚急性斯坦福大学A型主动脉夹层患者，在体外循环脑循环保护下，在TEVAR期间采用原位半导体激光开窗术治疗回顾性记录并评估常规术后结局。在3、6和12个月后的随访期间进行计算机断层扫描血管造影（CTA）。53例患者（91.4%）获得手术成功。平均手术时间为162 +/- 36分钟。1例患者在介入治疗过程中死于心包填塞，1例患者在介入治疗后死于重症肺炎。除两例轻微中风外，在干预后30天和12个月没有发生与开窗相关的并发症。CTA成像显示，随访期间，TEVAR后左锁骨下动脉和颈动脉的一期通畅率为100%，主动脉重塑良好。两名患者有Ia型内漏，另一个II型endoleak.Conclusions：在原位二极管激光开窗术TEVAR治疗A型主动脉夹层被认为是可行的，安全的，有效的，并可能是有益的，作为一种微创的方法。
Aims: The aim of the study was to evaluate the feasibility, safety, and effectiveness of in situ diode laser fenestration of thoracic endovascular aortic repair (TEVAR) stent grafts to treat Stanford type A aortic dissection.Methods and results: Fifty-eight patients with acute or subacute Stanford type A aortic dissection treated with in situ diode laser fenestration during TEVAR under cerebral circulation protection with an extracorporeal bypass were reviewed retrospectively. Routine postoperative outcomes were recorded and assessed. Computed tomography angiography (CTA) was performed during the follow-up after 3, 6 and 12 months. Procedural success was achieved in 53 patients (91.4%). The average procedure time was 162 +/- 36 minutes. One patient died of pericardial tamponade during intervention, and one died of severe pneumonia after the intervention. Except for two minor strokes, no more fenestration-related complications occurred at 30 days and 12 months after the intervention. CTA imaging demonstrated 100% primary patency for the left subclavian artery and carotid arteries with favourable aortic remodelling after TEVAR during the follow-up. Two patients had a type Ia endoleak and one other a type II endoleak.Conclusions: In situ diode laser fenestration during TEVAR for type A aortic dissection was found to be feasible, safe, and effective, and may be beneficial as a less invasive approach.