Outcomes Of Chimney Technique For Aortic Arch Diseases: A Single-Center Experience With 226 Cases
Outcomes Of Chimney Technique For Aortic Arch Diseases: A Single-Center Experience With 226 Cases
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烟囱技术治疗主动脉弓疾病的结果：226 例单中心经验
DOI：
10.2147/cia.s222948
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发表时间：
2019-01-01
影响因子：
3.6
通讯作者：
Jiang, Zhisheng
中科院分区：
文献类型：
--
作者：
Huang, Wenhui;Ding, Huanyu;Jiang, Zhisheng
目的：本研究的目的是记录单中心烟囱技术治疗主动脉弓疾病的经验。患者和方法：2012年8月至2017年10月，226例主动脉弓疾病患者（平均年龄54±12岁，男性197例）行胸椎血管内主动脉修复联合烟囱支架手术。主动脉支架在0区（n=22）、1区（n=13）或2区（n=191）放置。结果：技术成功率84%(189/226)，发生即时Ia型内漏37例（16%）。30天死亡率和发病率分别为2%（4/ 226）和4%（8/226）。主要不良事件包括4次中风、3次脊髓缺血和1次早期主动脉破裂。临床随访率98%(218/222)，影像学随访率78%（173/222）。临床随访和影像学随访的平均时间分别为22 +/- 16个月和20 +/- 15个月。6例（3%）患者出现左侧锁骨下动脉烟囱支架阻塞。随访期间，5例患者死亡（2%），2例发生严重中风（1%）。1例患者（0.5%）接受了再干预。结论：烟囱技术治疗不同主动脉弓病变是一种安全有效的方法。评估烟囱支架的永久性和降低即刻ELIa发生率需要注意。
Purpose: The goal of present study is to document our single-center experience with chimney technique for aortic arch diseases.Patients and methods: From August 2012 to October 2017, 226 patients (mean age 54 +/- 12 years; 197 men) with aortic arch diseases underwent thoracic endovascular aortic repair combined with chimney stents. The aortic stent-grafts were deployed in zone 0 (n=22), zone 1 (n=13), or zone 2 (n=191).Results: The technical success rate was 84% (189/226) and immediate type Ia endoleak (ELIa) happened in 37 (16%) patients. The 30-day mortality and morbidity rates were 2% (4/ 226) and 4% (8/226), respectively. Major adverse events include four major strokes, three spinal cord ischemia and one aortic rupture in the early-term. The clinical and imaging follow-up rates were 98% (218/222) and 78% (173/222), respectively. The average lengths of clinical and imaging follow-up were 22 +/- 16 months and 20 +/- 15 months, respectively. Chimney stent obstructions in left subclavian arteries were recorded in six (3%) patients. During follow-up, five patients died (2%) and two major strokes occurred (1%). One patient (0.5%) underwent reintervention.Conclusion: The current study documented that the chimney technique is effective and safe for treating aortic arch diseases in different aortic zones. Cautions are needed to assess the permanency of chimney stent and to reduce the immediate ELIa rate.