Usefulness of fenestrated stent grafts for thoracic aortic aneurysms
Usefulness of fenestrated stent grafts for thoracic aortic aneurysms
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DOI：
10.1093/ejcts/ezt127
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发表时间：
2013-10-01
影响因子：
3.4
通讯作者：
Adachi, Hideo
中科院分区：
文献类型：
--
作者：
Yuri, Koichi;Yokoi, Yoshihiko;Adachi, Hideo
优点：血管内覆膜支架（SG）是修复主动脉瘤的一种新型治疗方法。然而，主动脉弓的腔内修复术仍然具有挑战性。一般来说，修复具有SG的部位需要解剖外旁路。我们在2006年引入了主动脉弓SG修复术，并在每个主动脉弓分支战略性定位开窗。该手术不需要解剖外旁路。本研究评价了开孔型SG治疗的早期和中期结局。方法：我们回顾性分析了2006年1月至2012年3月在我科进行的383例单胸主动脉瘤修复术中，80例开孔型SG修复术中的24例的早期和中期结局。结果：100%的患者获得了技术成功。然而，由于淋浴栓塞，30天围手术期死亡率为4.1%（1/24）。1例患者在中位随访时间25.1个月内发生2型内漏，无动脉瘤扩大。然而，迁移或设备相关的并发症，需要额外的procedures.CONCLUSIONS：治疗与开孔型SGs不需要手术转位的弓分支。该手术适用范围广，侵入性小，结局良好。
OBJECTIVES: Endovascular stent grafts (SGs) comprise a novel therapeutic approach to repairing aortic aneurysms. However, endovascular repair of the aortic arch remains challenging. Generally, the repair of sites with SGs requires an extra-anatomical bypass. We introduced SG repair of the aortic arch with strategically positioned fenestrations for each arch branch in 2006. An extra-anatomical bypass is not required for this procedure. This study evaluates the early and mid-term outcomes of fenestrated SG treatment.METHODS: We retrospectively analysed the early and mid-term outcomes of 24 of 80 repairs with fenestrated SG among 383 single thoracic aortic aneurysm repairs that were undertaken at our department between January 2006 and March 2012.RESULTS: Technical success was obtained in 100% of the patients. However, there was a 30-day perioperative mortality rate of 4.1% (1 of 24) due to a shower embolism. One patient developed a Type 2 endoleak without aneurysm enlargement within a median follow-up time is 25.1 months. However, migrations or device-related complications requiring additional procedures did not arise.CONCLUSIONS: Treatment with fenestrated SGs does not require surgical transposition of the arch branches. The procedure is widely applicable and less invasive and outcomes are excellent.