文章摘要

开窗支架治疗慢性主动脉夹层远端破口的现状

作者: 1孟 庆友
1 苏州大学附属第一医院 心血管外科/ 苏州大学心血管病研究所,江苏 苏州 215006
通讯: 孟 庆友 Email: mengqy@163.com
DOI: 10.3978/.2018.06.004

摘要

主动脉夹层起病急,而且凶险,是一类灾难性疾病。在度过急性期后,无论是 Stanford A 型或 B 型,一部分发展成为慢性夹层动脉瘤,外科手术创伤巨大,近年腔内修复技术作为一种补充手段,取得较好的临床效果。开窗支架治疗慢性主动脉夹层远端破口,刚刚起步,短期也取得较好的临床效果,但无良好锚定区、真腔狭小、内脏分支动脉开口假腔是这一技术的瓶颈,面临很多技术挑战。一些新的思路,如“开”、“凿”、“疏“、“扩” 对这一技术的开展会有所帮助。
关键词: 动脉瘤,夹层;主动脉;血管内操作;支架

Fenestrated stent-grafts for distal tears of chronic aortic dissection: current status

Authors: 1MENG Qingyou
1 Department of Cardiovascular Surgery, the First Affiliated Hospital, Soochow University/Research Institute for Cardiovascular Diseases, Soochow University, Suzhou, Jiangsu 215006, China

CorrespondingAuthor:MENG Qingyou Email: mengqy@163.com

Abstract

Aortic dissection is a catastrophic condition characterized by sudden onset and high risk. Some patients with either Stanford type A or B aortic dissection will develop a chronic dissecting aneurysm aft er an acute stage, for which, open surgery will cause severe trauma. In recent years, endovascular repair which emerged as an alternative has achieved favorable clinical results. Using fenestrated stent-grafts for repair of distal tears of chronic aortic dissection has just been initiated, and has shown good short-term results. However, lack of good landing zone, narrow true lumen, and false lumen in the origin of the visceral branches are bott lenecks for this technology, and it faces many challenges in these respects. Some new ways of thinking, such as "opening", "chiseling", "dredging" and "expanding", will help to promote this technology.
Keywords: Aneurysm Dissecting; Aorta; Endovascular Procedures; Stents