外科理论与实践2017，Vol.22Issue(4)：303-309,7.DOI:10.16139/j.1007-9610.2017.04.008
平行支架技术在腔内修复主动脉夹层保留弓上分支动脉中的应用
Use of parallel stent technique in thoracic endovascular aortic repair of aortic dissection involving supra-aortic branch
摘要
Abstract
Objective To compare the results of different parallel stent techniques (chimney techniques) in different zones of aortic arch so as to provide evidence to decrease the complications and re-intervention rate of chimney thoracic endovascular repair(cTEVAR). Methods Between April 2011 and April 2016, 234 patients with aortic dissection involving supra-aortic branch received cTEVAR. A total of 156 cases (66.7%) received single-chimney (SC), 48 cases (20.5%) with double-chimneys (DC) and 30 cases (12.8%) with triple-chimneys (TC). Totally 342 chimneys were used with 321 (93.9%) chimneys anterograde chimney (AC) and the other 21 (6.1%) retrograde chimney (RC). Results The median follow-up was 27(8-56) months. All chimney grafts were successfully implanted, and Neither migration nor occlusion was observed during the period of follow-up. Mortality of this study was 1.7% (4/234). Three cases (1.3%) suffered from cerebral vascular events. Seventy-five cases (32.1%) had type Ⅰendoleak. Twenty-seven cases (36.0%) of them were found the endoleak disappeared in the follow-up period. Thirty-three case (44.0%) with false lumens were found stable, of whom 15 cases (20%) were found expanded and were re-treated by endoleak embolization successfully. When the proximal tear located in Zone I, there was higher endoleak rate than those in Zone C, S and N2 (P=0.041; P=0.042; P=0.009). TC were found to have more endoleak than SC (P<0.001) and DC (P=0.012). However, there was no significant difference of endoleak rate between TC, SC and DC during the follow-up. Conclusions TC and the proximal tear located in Zone I had higher en-doleak rate. Larger sample and longer follow-up would be required to evaluate durability and validity of the parallel stent technique.关键词
平行支架技术/烟囱腔内修复术/烟囱支架/主动脉夹层/主动脉弓Key words
Parallel stent technique/Chimney thoracic endovascular repair/Chimney graft/Aortic dissection/Aortic arch分类
医药卫生引用本文复制引用
赵玉玺,冯家烜,周建,严晓南,李振江,刘军军,冯睿,景在平..平行支架技术在腔内修复主动脉夹层保留弓上分支动脉中的应用[J].外科理论与实践,2017,22(4):303-309,7.基金项目
国家自然科学基金(81330034,81270386,81500369) （81330034,81270386,81500369）
