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腘动脉瘤患者腔内修复的临床分析

Endovascular treatment of popliteal artery aneurysm in a clinical analysis of 9 cases

摘要:

目的 评价腘动脉瘤PAA(PAA)腔内修复的效果和其治疗经验.方法 对2006年10月至2014年12月在复旦大学附属中山医院血管外科接受腔内修复的9例PAA患者的临床资料进行回顾性分析.男性8例,女性1例;年龄55 ~ 84岁,平均(66±15)岁.无症状PAA患者3例,有症状者6例.患者术前均完成CT血管造影检查.9例患者包含10个PAA,动脉瘤平均直径为3.9 cm(2.1 ~8.2 cm).结果 9例患者腔内修复均取得技术成功.围手术期并发症2例,其中1例为穿刺点血肿,1例术后出现局部足趾血管栓塞.中位随访时间33个月(3~87个月),随访中2例PAA出现支架内血栓形成,行溶栓治疗后再通.覆膜支架修复PAA的1年通畅率为78.8%.1例出现支架断裂.1例患者腔内修复术后15个月因脑干出血死亡.结论 腔内修复PAA的短中期疗效安全有效,但需密切关注远期并发症.

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abstracts:

Objective To evaluate the efficacy of endovascular repair of popliteal artery aneurysm (PAA) and to summarize the clinical experience and lessons.Methods A clinical data of 9 PAA cases (males 8, females 1, age range 55-84) undergoing endovascular repair from October 2006 to December 2014 at Zhongshan Hospital Fudan University were retrospectively analyzed.CT angiography was made in all of the 9 cases preoperatively, and 10 PAA were included in the analysis.Of the 9 cases, 6 cases were symptomatic.The mean diameter of PAA was 3.9 cm (range, 2.1-8.2).Results The technique successful rate of endovascular repair was 10/10.The preoperative complications were 2/10, including one case suffered hematoma in the arterial puncture site and 1 case with distal artery embolization.The mean follow-up was 33 months (range, 3-87).During the follow-up, 2 cases received the secondary intervention and drug thrombolysis because of the stent distal thrombosis.The stent-graft primary patency at 1 year was 78.8% (95% CI: 48%-91%).One case suffered stent fracture, and one case died of brainstem hemorrhage 15 months post endovascular repair of PAA.Conclusions Endovascular treatment of PAA is safe and effective in perioperative and midterm follow-up.However, individual endovascular strategy and postoperative complications in the long-term follow-up should be payed more attention.

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作者: 郭宝磊 [1] 符伟国 [1] 郭大乔 [1] 徐欣 [1] 陈斌 [1] 蒋俊豪 [1] 杨珏 [1] 史振宇 [1]
第一作者: 郭宝磊
期刊: 《中华外科杂志》2016年54卷2期 99-103页 MEDLINEISTICPKUCSCD
栏目名称: 论著
DOI: 10.3760/cma.j.issn.0529-5815.2016.02.005
发布时间: 2016-03-15
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