摘要
腹主动脉瘤（AAA）常发生于老年人,破裂是其最常见、最凶险的并发症,病死率可高达63％。传统开腹性手术是治疗AAA十分有效的手段,但对于高危患者其病死率显著增加。因此,发展一种微创方法治疗AAA对于降低病死率十分必要。经股动脉放置血管内支架-移植物是治疗AAA的一个重要里程碑,尤其对于那些高危患者。这一新技术作为外科修复的替代疗法已经得到广泛的应用。内支架-移植物植入后的常见并发症包括内漏、移植物移位或变形和移植物血栓形成,以内漏最常见且最重要。内漏是指移植物植人后仍有持续性血液进入动脉瘤囊,主要通过某些影像学技术证实,螺旋CT增强检查是检出内漏的首选方法。术后30天内发生的或早期内漏可通过一段时期观察,然后对持续性内漏进行血管内介入治疗,30天后的晚发内漏应及时进行介入处理,无观察期。
Abdominal aortic aneurysm(AAA) is a relatively common disease among the elderly population. The rupture of AAA is the most common complication and also the most dramatic. Rupture is related to significant mortality of up to 63% .Conventional open surgical repair is quite effective,however,in the population with a higher risk level,the mortality significantly increase.The development of less invasive techniques to treat AAA derived from the necessity to reduce the mortality.The development of trans-femoral placement of an endovascular stent - graft was a significant landmark in the management of those patients with AAA, especially in high - risk patients.This new technique is increasingly being used as an alternative to surgical repair.The common complications following stent - grafts include endoleak, stent - graft migration, deformation and graft thrombosis. Among them, endoleak is the most common and important complication. Endoleak is defined as the persistence of perfusion of aneurysmal sac after endovascular therapy and demonstrated by some form of imaging studies. Contrast enhanced helical computed tomography (EHCT) is considered as the imaging technique of first choice for the detection of endoleak . Patients who develop an early endoleak, within 30 days, should be treated by a period of observation and secondary endovascular intervention is persistent case. Patients who develop a late endoleak should be treated similarly without a period of observation.
出处
《中国医学计算机成像杂志》
CSCD
2002年第2期101-107,共7页
Chinese Computed Medical Imaging
