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腔内人造血管内支撑术在血管外科中的应用 |
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符伟国 王玉琦 陈福真 叶建荣 郭大乔 陈斌 杨珏
【摘 要】 目的 评价腔内人造血管内支撑术在治疗血管外科疾病中的早期临 床疗效。方法 9例病人接受腔内人造血管内支撑术治疗。 其中腹主动脉瘤6例, 左锁骨下动脉瘤1例, 左髂总动静脉瘘1例, 左髂股动 脉重度硬化性狭窄1例。术前均行Duplex彩超、四肢节段性测压(PVL)和DSA造影, 6例动脉瘤 病人术前行三维重建螺旋CT。结果 术后即刻DSA造影显示, 7例动脉瘤消失, 近 远端人造血管与宿主动脉结合处均未见渗漏；1例左髂动静脉瘘及瘤体消失；1例左髂股动脉 重度狭窄消失, 人造血管通畅；1例腹主动脉瘤因急性肾功能衰竭于术后第3天死亡。临床成 功率88.88%。术后1年螺旋CT或Duplex随访显示：5例腹主动脉瘤和1例髂总动静脉瘘腔内人 造血管无移位, 无渗漏, 动脉瘤腔无增大；1例左髂股动脉重度狭窄术后间歇性跛行消失；1 例锁骨下动脉瘤术后存在少量渗漏, 2个月后自行闭合。结论 近期随访表明, 腔内人造血管内支撑术是一种创伤小、恢复快, 治疗腹主动脉瘤安全有效的新方法, 但远期 疗效还有待进行继续随访。
【关键词】 腹主动脉瘤 动静脉瘘 动脉硬化闭塞性 腔内人造血管
The clinical application of endovascular techniques for management of vasculard iseases
Fu Weiguo, Wang Yuqi，Chen Fuzhen，et al.
(Department of Vascu lar Surgery，Zhongshan Hospital，Shanghai Medical University，Shanghai 200032)
【Abstract】 Objective To evaluate the preliminary clinical result s of the endovascular procedures for management of the vascular diseases in a re trospective study.Methods Between February 1998 and February 1999， 9 patients with 6 infrarenal abdomi nal aortic aneurysms，1 left common iliac arteriovenous fistula，1 left subc lavicular artery aneurysm and 1 severe stenosis in left common iliac artery were en rolled in Shanghai Zhongshan Hospital.Duplex，PVL and angiography were perfo rmed in each patient preoperatively.Computed tomography was performed in 6 pati ents with AAA and MRI in 1 case with severe stenosis in left common iliac artery preoperatively.The endovascular procedures were performed in all patients.Results The postoperative angio graphy showed all aneurysms and arteriovenous fistula were excluded by endograft s，no endoleaks in the proximal or distal connections were detected and the sten osis disappeared.One patient died of renal failure 72 hours after the proced ure because of the prolonged operative time and excessive contrast medium.Clinic al success at 30 days was 88.88%.In the 12-month follow-up of 9 cases，no mig ration，large endoleak and inc[1] [2] [3] 下一页
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