摘要
目的探讨胸主动脉腔内修复术(TEVAR)中覆盖左锁骨下动脉(LSA)的临床疗效。方法选取福建医科大学附属协和医院2007年1月至2017年12月收治283例因支架近端锚定区不足而选择性覆盖LSA的胸主动脉腔内修复术患者,其中部分覆盖159例(A组)、完全覆盖124例(B组)。随访及观察治疗后临床疗效。结果283例患者均成功植入覆膜支架,围术期中两组患者各出现2例死亡。两组患者在左上肢缺血发生率分别为3.77%和41.13%,头晕发生率分别为1.26%和37.10。结论TEVAR术中选择性覆盖LSA有一定的安全性及可行性,部分覆盖LSA更为安全可靠,但要严格把握其适应证,对存在高危因素的患者应选择重建LSA血运。
Objective To investigate the clinical effect of left subclavian artery(LSA)in thoracic aortic endovascular repair(TEVAR).Method From January 2007 to December 2017,283 patients with selective coverage of LSA due to lack of proximal anchorage area of the stent were selected from the Union Hospital Affiliated to Fujian Medical University,including 159 patients with partial coverage(group A)and 124 patients with complete coverage(group B).Follow up and observe the clinical effect after treatment.Result The stent graft was successfully implanted in 83 patients,and 2 patients died in each group.The incidence of left upper limb ischemia was 3.77%and 41.13%in the two groups,and the incidence of dizziness was 1.26%and 37.10%,respectively.Conclusion Selective coverage of LSA in TEVAR has certain safety and feasibility,and partial coverage of LSA is more safe and reliable,but the indications should be strictly controlled.Patients with high risk factors should choose to reconstruct LSA blood supply.
作者
江德斌
陈良万
谢先标
戴小福
卢衡
邱罕凡
Jiang Debin;Chen Liangwan;Xie Xianbiao;Dai Xiaofu;Lu Heng;Qiu Hanfan(Department of Cardiovascular Surgery,Xiehe Hospital,Fujian Medical University,Heart Center of Fujian Province,Fuzhou 350001,Fujian,China)
出处
《血管与腔内血管外科杂志》
2020年第1期10-13,31,共5页
Journal of Vascular and Endovascular Surgery
基金
国家自然科学基金项目《机械牵张诱导主动脉夹层血管平滑肌细胞表型转化的机制研究》(81670438).
关键词
左锁骨下动脉
胸主动脉
腔内修复术
锚定区
left subclavian artery
thoracic aorta
endovascular repair
landing zone
