目的建立兔腹主动脉分叉双支架术模型。方法雄性新西兰兔5只(体质量3.0~3.5 kg),麻醉消毒后,经颈动脉途径于腹主动脉-髂动脉血管分叉处采用边支支架微突T支架技术(T-stenting and small protrusion,TAP)实施双支架植入术,利用数字减影...目的建立兔腹主动脉分叉双支架术模型。方法雄性新西兰兔5只(体质量3.0~3.5 kg),麻醉消毒后,经颈动脉途径于腹主动脉-髂动脉血管分叉处采用边支支架微突T支架技术(T-stenting and small protrusion,TAP)实施双支架植入术,利用数字减影血管造影(digital subtraction angi-ography,DSA)、血管内超声(intravascular ultrasound,IVUS)和显微CT扫描(micro computed tomography,micro-CT)进行术后即刻评价及术后6个月复查。结果可通过兔颈动脉放置6F鞘管,于腹主动脉分叉处成功实施TAP双支架术,术后即刻DSA提示支架位置满意,血流TIMI 3级,IVUS提示支架贴壁良好,术后6个月复查DSA提示无支架内再狭窄及血栓形成,血流TIMI 3级,IVUS提示支架贴壁良好,无支架内再狭窄,micro-CT可见边支开口处支架覆盖完全,无支架内血栓,右侧髂动脉支架下缘微突入腹主动脉管腔[(0.49±0.08)mm]。结论成功建立了兔腹主动脉分叉双支架术模型,为冠脉分叉病变的临床前期研究提供了依据。展开更多
Approximately 20%-40% of patients with abdominal aortic aneurysms can have unilateral or bilateral iliac artery aneurysms and/or ectasia. This influences and compromises the distal sealing zone during endovascular ane...Approximately 20%-40% of patients with abdominal aortic aneurysms can have unilateral or bilateral iliac artery aneurysms and/or ectasia. This influences and compromises the distal sealing zone during endovascular aneurysm repair. There are a few endovascular techniques that are used to treat these types of aneurysms, including intentional occlusion/over-stenting of the internal iliac artery on one or both sides, the "bell-bottom" technique, and the more recent method of using an iliac branch stent graft. In some cases, other options include the "snorkel and sandwich" technique and hybrid interventions. Pelvic ischemia, represented as buttock claudication, has been reported in 16%-55% of cases; this is followed by impotence, which has been described in 10%-17% of cases following internal iliac artery occlusion. The bellbottom technique can be used for a common iliac artery up to 24 mm in diameter given that the largest diameter of the stent graft is 28 mm. There is a paucity of data and evidence regarding the "snorkel and sandwich" technique, which can be used in a few clinical scenarios. The hybrid intervention is comprised of a surgical operation, and is not purely endovascular. The newest branch stent graft technology enables preservation of the anterograde flow of important side branches. Technical success with the newest technique ranges from 85%-96.3%, and in some small series, technical success is 100%. Buttock claudication was reported in up to 4% of patients treated with a branch stent graft at 5-year follow-up. Mid- and short-term follow-up results showed branch patency of up to 88% during the 5-6-year period. Furthermore, branch graft occlusion is a potential complication, and it has been described to occur in 1.2%-11% of cases. Iliac branch stent graft placement represents a further development in endovascular medicine, and it has a high technical success rate without serious complications.展开更多
文摘Approximately 20%-40% of patients with abdominal aortic aneurysms can have unilateral or bilateral iliac artery aneurysms and/or ectasia. This influences and compromises the distal sealing zone during endovascular aneurysm repair. There are a few endovascular techniques that are used to treat these types of aneurysms, including intentional occlusion/over-stenting of the internal iliac artery on one or both sides, the "bell-bottom" technique, and the more recent method of using an iliac branch stent graft. In some cases, other options include the "snorkel and sandwich" technique and hybrid interventions. Pelvic ischemia, represented as buttock claudication, has been reported in 16%-55% of cases; this is followed by impotence, which has been described in 10%-17% of cases following internal iliac artery occlusion. The bellbottom technique can be used for a common iliac artery up to 24 mm in diameter given that the largest diameter of the stent graft is 28 mm. There is a paucity of data and evidence regarding the "snorkel and sandwich" technique, which can be used in a few clinical scenarios. The hybrid intervention is comprised of a surgical operation, and is not purely endovascular. The newest branch stent graft technology enables preservation of the anterograde flow of important side branches. Technical success with the newest technique ranges from 85%-96.3%, and in some small series, technical success is 100%. Buttock claudication was reported in up to 4% of patients treated with a branch stent graft at 5-year follow-up. Mid- and short-term follow-up results showed branch patency of up to 88% during the 5-6-year period. Furthermore, branch graft occlusion is a potential complication, and it has been described to occur in 1.2%-11% of cases. Iliac branch stent graft placement represents a further development in endovascular medicine, and it has a high technical success rate without serious complications.
