中国普通外科杂志2023，Vol.32Issue(12)：1864-1871,8.DOI:10.7659/j.issn.1005-6947.2023.12.005
主动脉定制开窗支架治疗主动脉弓动脉瘤中国首例报告(附视频)
Customized fenestrated aortic stent-graft for aortic arch aneurysm:report of first case in China(with video)
摘要
Abstract
Background and Aims:Thoracic endovascular aortic repair(TEVAR)has gradually become a the first-line therapeutic option for thoracic diseases.However,hindered by the complex anatomical structure of the aortic arch,effectively reconstructing supra-arch arteries during lesion treatment is a common challenge when using current standardized products.Given this,our team,collaborating with a stent manufacturer,had developed the Castor customized fenestrated thoracic stent-graft(hereafter referred to as Castor customized fenestrated stent)and successfully performed the first case of Castor customized fenestrated stent implantation in China.This article provides a report on this. Methods:The clinical data,stent customization details,and surgical procedure for the first case of Castor customized fenestrated stent implantation in China were described,and an analysis of the advantages and disadvantages of the Castor customized fenestrated stent and review of relevant literature were also conducted. Results:The patient,a 59-year-old male who underwent TEVAR 14 years ago,developed an aortic arch aneurysm involving the left subclavian artery(LSA)and left common carotid artery(LCCA).With the patient's and family's consent,we utilized the Castor fenestrated stent to seal the aneurysm.The surgical plan involved using the Castor customized fenestrated stent to occlude the aneurysm and placing the Castor stent branch into the LCCA.Preoperatively,fenestrations were customized to separately reconstruct the innominate artery(IA)and LSA.Successful implantation of the Castor single branch stent was achieved during surgery,effectively reconstructing the three supra-arch arteries.Postoperative imaging confirmed satisfactory aneurysm occlusion with no endoleak,patent flow in the three branch arteries,and no occurrence of adverse events related to the aorta. Conclusion:The performance of the Castor individualized fenestrated stent is excellent,fitting the patient's anatomical characteristics,completely isolating the aneurysm,and enabling precise fenestration for reconstruction of the supra-arch arteries.Importantly,it avoids compromising stent integrity,providing a means for precise clinical interventions.关键词
主动脉瘤,胸/血管内操作/支架/精准医学Key words
Aortic Aneurysm,Thoracic/Endovascular Procedures/Stents/Precision Medicine分类
临床医学引用本文复制引用
潘柏宏,欧阳洋,凌晋,吴科敏,杨璞,黄建华,王伟..主动脉定制开窗支架治疗主动脉弓动脉瘤中国首例报告(附视频)[J].中国普通外科杂志,2023,32(12):1864-1871,8.基金项目
湖南省自然科学基金青年基金资助项目(2023JJ40976). （2023JJ40976）
