| 王梓彬,卢泽旭,张立科,等.直筒型覆膜支架体外双开窗重建弓上三分支治疗复杂主动脉弓部病变的效果[J].中国临床保健杂志,2026,29(2):184-190. |
| 直筒型覆膜支架体外双开窗重建弓上三分支治疗复杂主动脉弓部病变的效果 |
| Preliminary experience of double in vitro fenestration with straight tubular stent-graft for reconstructing three supra-aortic branches in complex aortic arch pathologies |
| 投稿时间：2026-02-24 |
| DOI：10.3969/J.issn.1672-6790.2026.02.008 |
| 中文关键词: 血管成形术 主动脉疾病 血管内操作 支架 |
| 英文关键词: Angioplasty Aortic diseases Endovascular procedures Stents Fund program:Hebei Provincial Medical Scientific Research Project |
| 基金项目:河北省医学科学研究项目 |
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| 中文摘要: |
| 目的 探讨直筒型覆膜支架体外双开窗重建弓上三分支治疗复杂主动脉弓部病变的安全性和有效性。方法 回顾性分析2025年6—12月河北医科大学第一医院血管外科收治的4例复杂主动脉弓部病变患者的临床资料,其中Stanford A型壁间血肿1例、Stanford B型主动脉夹层2例、主动脉弓动脉瘤(术后内漏相关)1例。4例均采用直筒型覆膜支架体外双开窗技术:近端开大窗对位无名动脉和左颈总动脉,远端开小窗对位左锁骨下动脉,同期重建弓上三分支。结果 4例手术均顺利完成,术中造影示弓上三分支血流通畅,1例术后出现少量内漏,经弹簧圈栓塞后内漏消失；患者术后胸背部疼痛明显缓解,四肢活动正常,无神经系统并发症及死亡病例。结论 直筒型覆膜支架体外双开窗技术可简化弓上三分支重建的体外操作流程。本组4例解剖适宜的复杂主动脉弓部病变患者采用该技术后均取得了良好的即时技术成功。 |
| 英文摘要: |
| Objective To evaluate the safety and efficacy of a straight tubular stent-graft with double in vitro fenestration for single-stage reconstruction of the three supra-aortic branches in patients with complex aortic arch pathologies.Methods A retrospective analysis was conducted on four consecutive patients treated between June and December 2025.The cohort included one Stanford type A intramural hematoma,two Stanford type B aortic dissections,and one aortic arch aneurysm secondary to a prior type Ia endoleak.All procedures utilized a physician-modified,straight tubular thoracic endograft featuring a large proximal fenestration for the innominate and left common carotid arteries and a small distal fenestration for the left subclavian artery.Results Technical success was achieved in all cases,with intraoperative angiography confirming patent flow in all supra-aortic branches.One patient developed a minor proximal endoleak,which was successfully resolved with coil embolization.Postoperatively,chest and back pain resolved in symptomatic patients,and no neurological complications,limb dysfunction,or mortality occurred during the perioperative period.Conclusions The double fenestration technique of the straight tube covered stent in vitro can simplify the in vitro operation process of the three-branch reconstruction above the aortic arch.All four patients with complex aortic arch lesions suitable for anatomy in this group achieved good immediate technical success after using this technique. |
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