主动脉疾病专题研究(Monographic Study of Aortic Diseases)

平肾腹主动脉闭塞的介入治疗:附14 例报告

Published at: 2015年第24卷第6期

赵俊来 1,2 , 张小明 1 , 张学民 1 , 蒋京军 1 , 李清乐 1 , 贺致宾 1 , 李伟 1
1 北京大学人民医院 血管外科,北京 100044
2 北京清华长庚医院 血管外科,北京 102218
DOI: 10.3978/j.issn.1005-6947.10.3978/j.issn.1005-6947.2015.06.006
基金:

摘要

目的:总结平肾腹主动脉闭塞病变的介入治疗经验。方法:回顾性分析2012 年3 月—2014 年11 月收治的14 例平肾腹主动脉闭塞患者资料,其中男9 例,女5 例; 年龄42~71 岁。临床表现间歇性跛行8 例, 静息痛5 例, 足趾坏疽1 例(7.2%); 病程1~72 个月。所有患者均行多侧孔溶栓导管溶栓后覆膜支架植入治疗。结果:均成功所有患者完成操作。置管溶栓后仅2 例肾动脉附近腹主动脉仍可见少量附壁血栓,其余患者腹主动脉内血栓均明显消失。患者均行Kissing 技术覆膜支架植入,术后患者下肢缺血症状均明显改善。并发症发生率7.1%,仅1 例溶栓后出现后腹膜血肿。随访1~26 个月,平均14.8 个月,通畅率78.6%。结论:置管溶栓联合覆膜支架置入是一种安全有效的平肾腹主动脉闭塞腔内治疗方法。


Interventional therapy for juxtarenal aortic occlusion: a report of 14 cases

Abstract

Objective: To describe the experience in endovacular treatment of juxtarenal aortic occlusions. Methods: The clinical data of 14 patients with juxtarenal aortic occlusion admitted from March 2012 to November 2014 were retrospectively analyzed. Of the patients, 9 cases were male and 5 cases were female; ages ranged from 42 to 71 years; 8 cases presented with intermittent claudication, 5 cases manifested as rest pain, and one case had toe gangrene, and the course of disease ranged from one month to 72 months. All patients received covered stent implantation after thrombolysis via a multi–side-hole catheter. Results: Interventional procedures were successfully completed in all patients. The thrombi in the abdominal aorta disappeared after catheter-directed thrombolysis in all patients except two cases, in whom little mural thrombi remained. All patients received covered kissing stent placement, after which, their symptoms of limb ischemia were significantly relieved. Follow-up period ranged from one month to 26 months, with average of 14.8 months, and the patency rate was 78.6%. Conclusion: Thrombolytic therapy combined with covered stent placement is a safe and effective endovascular treatment method for juxtarenal aortic occlusion.


comments powered by Disqus

全文

引用

引用本文: 俊来 赵, 小明 张, 学民 张, 京军 蒋, 清乐 李, 致宾 贺, 伟 李. 平肾腹主动脉闭塞的介入治疗:附14 例报告[J]. 中国普通外科杂志, 2015, 24(6): 800-803.
Cite this article as: ZHAO Junlai, ZHANG Xiaoming, ZHANG Xuemin, JIANG Jingjun, LI Qingle, HE Zhibin, LI Wei . Interventional therapy for juxtarenal aortic occlusion: a report of 14 cases[J]. Chin J Gen Surg, 2015, 24(6): 800-803.