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覆膜Cheatham-Platinum支架治疗主动脉缩窄九例早中期结果

Early and midterm results of covered Cheatham-Platinum stent for treatment of aortic coarctation: a report of 9 cases

摘要:

目的 评价覆膜Cheatham-Platinum(CP)支架治疗青少年及成人主动脉缩窄(CoA)的早中期疗效.方法 从2007年1月到2011年6月,本中心对9例连续收治的CoA患者实施覆膜CP 支架置入术,其中男性4例,女性5例;年龄13~44岁,平均年龄(24±11)岁.根据DSA结果选择覆膜CP支架和balloon-in-balloon球囊(BIB球囊),支架定位准确后先后充盈内外球囊扩张覆膜CP支架.对比覆膜CP支架置入前后CoA跨狭窄段收缩压力差变化、狭窄程度变化等指标.结果 覆膜CP支架置入前后CoA跨狭窄段收缩压差由术前(66±21)mmHg下降为术后(9±4)mmHg(1 mmHg =0.133 kPa,t =9.13,P=0.000),病变部位狭窄程度由术前79%±12%下降为术后17%±4%(t=16.65,P=0.000).随访4~54个月,平均(33±22)个月,所有病变支架内无再狭窄,上下肢收缩压力差不超过15 mmHg.结论 覆膜CP支架对治疗青少年及成人CoA早中期结果安全有效,其远期结果有待进一步随访.

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abstracts:

Objective To evaluate the early and midterm results of covered Cheatham-Platinum (CP) stent for treatment of aortic coarctation (CoA) in adolescents and adults.Methods From January 2007 to June 2011,9 consecutive cases of CoA underwent covered CP stent implantation.There were 4 male and 5 female patients,aging from 13 to 44 years with a mean of (24 ± 11 ) years.The covered CP stent and balloon-in-balloon catheter were selected according to digital substraction angiography measurements.The covered CP stents were expanded to appropriate diameter by inflation of the inner balloon and outer balloon successively.The systolic pressure gradient across the stenosis and narrowest degree of the stenotic vessels were compared before and after the procedure.Results After the procedure,the systolic pressure gradient across the stenosis decreased from (66 ±21 ) mmHg to (9±4) mmHg ( 1 mmHg =0.133 kPa,t =9.13,P =0.000) and the narrowest degree of CoA decreased from 79% ± 12% to 17 ± 4% ( t =16.65,P =0.000).During a mean follow-up of (33 ± 22 ) months (ranging 4 to 54 months),no intrastent restenosis were found and systolic pressure gradient from upper to low extremity was not more than 15 mmHg in each case.Conclusions Covered CP stent implantation is safe and effective for treatment of CoA in adolescents and adults.The early and midterm results are encouraging,but long term results require further follow-up and observation.

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作者: 熊江 [1] 郭伟 [1] 刘小平 [1] 贾鑫 [1] 马晓辉 [1] 王立军 [1] 张宏鹏 [1]
第一作者: 熊江
期刊: 《中华外科杂志》2012年50卷7期 629-632页 MEDLINEISTICPKUCSCD
分类号: R735.1
栏目名称: 论著
DOI: 10.3760/cma.j.issn.0529-5815.2012.07.015
发布时间: 2012-10-29
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