首页|激光原位开窗全腔内修复累及弓部主动脉夹层的临床结果及支架选择标准的单中心经验

激光原位开窗全腔内修复累及弓部主动脉夹层的临床结果及支架选择标准的单中心经验

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目的 报道单中心激光辅助原位开窗技术全腔内修复累及弓部主动脉夹层的临床结果以及支架选择标准的临床经验.方法 回顾性分析2016年1月至2023年4月在我院330例接受激光原位开窗腔内修复技术治疗的累及弓部主动脉夹层患者的临床资料,包括患者一般情况、手术操作、技术成功率、手术并发症等内容,总结临床治疗结果,分析主动脉支架及弓部分支动脉重建支架选择标准.结果 所有患者均接受了激光原位开窗辅助腔内修复术,手术时间(176±51)min,开窗技术成功率98.1％.院内死亡10例(3.03％),症状性中风8例(2.68％),内漏41例(12.4％),近端支架源性新发破口 2例(0.61％),无远端支架源性新发破口.随访CT血管造影(24±7.9)个月,结果显示分支血管通畅率为96.58％.结论 激光原位开窗全腔内修复累及弓部主动脉夹层成功率高,并发症发生率低,是安全且有效的方法.
Thoracic endovascular aortic repair with laser in situ fenestration of aortic dissection involving the arch:a single-center clinical outcomes and criteria of stent selection
Objective To report the clinical outcomes of thoracic endovascular aortic repair with laser in situ fenestra-tion of aortic dissection involving the arch in a single center,and to summarize the clinical experience of stent selection criteria.Methods The clinical data of 330 patients with aortic coarctation involving arch branches treated with thoracic endovascular aortic repair with laser in situ fenestration in our hospital from January 2016 to April 2023 were retrospec-tively analyzed,including the general information of patients,surgical procedures,technical success rate,and surgical complications.The clinical outcomes were summarized and the selection criteria for aortic stents and branch artery recon-struction stents were analyzed.Results All patients underwent thoracic endovascular aortic repair with laser in situ fen-estration,with a mean operation time of(176±51)minutes and a fenestration technique success rate of 98.1％.There were 10 in-hospital deaths(3.03％),8 symptomatic strokes(2.68％),41 endoleaks(12.4％),2 proximal stent-in-duced new entries(0.61％),and no distal stent-induced new entries were observed.Follow-up CT angiography[(24±7.9)months]demonstrated a branch vessel patency rate of 96.58％.Conclusion Laser in situ fenestration with thoracic endovascular repair of aortic dissection involving the arch is a safe and effective technique with a high success rate and a low complication rate.

Aortic dissectionAaortic archLaser in situ fenestrationEndovascular repairReconstruction of branched vesselStent

杜国栋、仇鹏、刘俊超、杨心蕊、吴小雨、崔超毅、秦金保、赵振、叶开创、刘光、刘晓兵、殷敏毅、王瑞华、陆信武

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上海交通大学医学院附属第九人民医院血管外科上海交通大学血管病诊治中心,上海 200011

主动脉夹层 主动脉弓部 激光原位开窗 腔内修复 分支重建 支架

上海市科技创新行动计划国家自然科学基金上海交通大学医学院附属第九人民医院临+计划安徽省卫生健康科研项目

20Y1190960082170411JYLJ202010AHWJ2022a031

2024

10.6040/j.issn.1671-7554.0.2024.320

山东大学学报(医学版)
山东大学

山东大学学报(医学版)

CSTPCD北大核心
影响因子：0.841
ISSN：1671-7554
年,卷(期)：2024.62(9)
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