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【摘要】目的 探討一體式分叉型覆膜支架應(yīng)用于介入治療孤立性髂動(dòng)脈瘤(IIAAs)的安全及有效性。方法 回顧性分析本中心自2011年8月至2016年7月，共7例男性患者，年齡49~22歲，平均年齡(69±10.5)歲，因IIAAs接受一體式分叉型覆膜支架介入治療。其中單側(cè)病變3例；雙側(cè)病變4例，4 例合并髂內(nèi)動(dòng)脈瘤。6例患者使用Microport Aegis-B—體式分叉型覆膜支架，1例使用Powerlink一體式分叉型覆膜支架，遠(yuǎn)端共使用9枚髂動(dòng)脈延長(zhǎng)支架。1例患者行髂內(nèi)動(dòng)脈預(yù)栓塞以避免II型內(nèi)漏。術(shù)后分別于1、6、12個(gè)月及以后每年一次行臨床及影像隨訪。結(jié)果：7例患者均成功置入一體式覆膜支架，技術(shù)成功率為100%。一體式支架主體近端直徑為24~26 mm，長(zhǎng)度為80~92 mm。6例患者單側(cè)髂內(nèi)動(dòng)脈開口覆蓋，1例患者雙側(cè)髂內(nèi)動(dòng)脈開口覆蓋，無(wú)盆腔及臀肌缺血發(fā)生，圍術(shù)期無(wú)嚴(yán)重并發(fā)癥發(fā)生。平均隨訪時(shí)間(32.55±19)個(gè)月(12~70個(gè)月)?；颊唠S訪期內(nèi)無(wú)支架移位，無(wú)支架相關(guān)死亡等嚴(yán)重并發(fā)癥。1例隨訪內(nèi)發(fā)現(xiàn)輕度II型內(nèi)漏。結(jié)論 一體式分叉型覆膜支架治療IIAAs安全有效，近中期療效滿意，特別是對(duì)于近端錨定區(qū)不足或雙側(cè)受累的患者有其獨(dú)到特殊的應(yīng)用優(yōu)勢(shì)。

【摘要】目的 探討一體式分叉型覆膜支架治療腹主動(dòng)脈及骼動(dòng)脈病變的療效。方法 本組31例患者應(yīng)用一體式分叉型覆膜支架治療，男26例，女5例；年齡38~84歲，平均(64.5±10.7)歲。腹主動(dòng)脈真性動(dòng)脈瘤17例，腹主動(dòng)脈穿通潰瘍5例，髂動(dòng)脈瘤4例(雙側(cè)受累2例)，腹主動(dòng)脈假性動(dòng)脈瘤2例，腹主動(dòng)脈瘤EVAR術(shù)后遠(yuǎn)端漏2例，腹主動(dòng)脈夾層1例。使用Microport Aegis(上海微創(chuàng))支架22例，Powerlink(ENDOLOGIX公司)支架9例。術(shù)后1、3、6、12個(gè)月及以后每年一次行檢查隨訪。結(jié)果 31例均成功置入支架，手術(shù)成功率100%。覆膜支架主體近端直徑20~28 mm，主體支架長(zhǎng)度120~240 mm；封閉一側(cè)髂內(nèi)動(dòng)脈13例，雙側(cè)動(dòng)內(nèi)動(dòng)脈均保留15例。隨訪3~36個(gè)月，支架內(nèi)血流通暢，無(wú)內(nèi)漏及支架移位發(fā)生。結(jié)論 一體式分叉型覆膜支架治療腎下腹主動(dòng)脈病變及動(dòng)動(dòng)脈病變近中期療效滿意，遠(yuǎn)期療效尚需長(zhǎng)期隨訪。

【摘要】Objectives: To report the midterm safety and efficacy of the Aegis
-B (Microport, Shanghai, China) unibody bifurcated stent graft for endovascular treatment of isolated abdominal aortic dissection (IAAD). Background: Isolated abdominal aorta dissection (IAAD) is a rare event. Endovascular stent grafts seem to offer an efficient therapeutic approach to treat IAAD. However, the relatively small diameter of the infrarenal aorta and aortic bifurcation remains the main anatomical limitation to endovascular repair. Methods: Between 2008 and 2015, we retrospectively evaluated 32 IAAD patients (21 men; mean age 58 ± 18 years), who underwent endovascular repair using Aegis
-B unibody bifurcated stent graft. Narrow proximal landing zone and narrow distal aorta was present in 11 (34.4%) patients and 10 (31.3%) patients, respectively. In the follow-up period, aortic remodeling was observed with computed tomography angiography. Results: All patients were treated by endovascular means, with a primary technical success rate of 100%. During a mean follow-up period of 30.71 ± 16.36 months (range, 8e56 months), no death, rupture, stent fracture, material failure, or device migration was observed. Complete false lumen thrombosis was observed in all patients at 1 year, and all patients were free from false lumen growth in the follow-up. Conclusions: Endovascular treatment of IAAD using the Aegis
-B system appears to be safe and effective. Results from this study suggest this algorithm can provide stable, secure fixation for IAAD patients with narrow proximal landing zone, and distal aorta.