新型国产覆膜支架腔内修复肾下型腹主动脉瘤的临床对照研究:近-中期随访结果与单中心经验总结

发布时间：2019-01-06 05:14

【摘要】：背景:受限于高昂的覆膜支架费用和有限的循证医学数据,腹主动脉瘤腔内修复术这一微创技术在国内的普及受到阻碍。为了降低费用,覆膜支架材料的国产化势在必行,但是之前国产腹主动脉瘤覆膜支架的循证医学数据仍然较少。目的:对比新型国产腹主动脉覆膜支架与进口覆膜支架(GORE EXCLUDER)腔内修复治疗腹主动脉瘤的效果。方法:回顾性分析2014年1至11月在青岛大学附属医院血管外科完成腹主动脉瘤腔内修复术32例肾下型腹主动脉瘤患者的临床资料,其中采用国产覆膜支架(华脉泰科)11例,GORE EXCLUDER覆膜支架21例。患者均为男性,年龄56-79岁,平均(70.2±6.9)岁。于术后第1,6个月及之后每6个月行主动脉计算机断层扫描血管造影检查评估治疗效果。结果与结论:(1)国产组支架组11例均成功植入华脉泰科覆膜支架,术后发现迟发Ⅰ型内漏1例,Ⅱ型内漏1例,1例术后髂支闭塞,1例死亡。共植入覆膜支架主体11枚,髂动脉覆膜支架18枚,Cuff支架1枚,裸支架1枚,平均2.8枚/人;(2)进口支架组21例均成功植入GORE EXCLUDER覆膜支架,技术成功率90%,术中造影发现Ⅰ型内漏2例(10%),术后复查发现Ⅰ型内漏2例,Ⅱ型内漏2例。共植入覆膜支架主体21枚,髂动脉覆膜支架28枚,Cuff支架3枚,平均2.47枚/人;(3)结果表明,新型国产腹主动脉覆膜支架治疗肾下腹主动脉瘤取得了满意的近-中期疗效,各观测指标与进口支架组差异无显著性意义。但是国产覆膜支架的远期疗效仍有待进一步研究。
[Abstract]:Background: limited by the high cost of stenting and limited evidence-based medical data endovascular repair of abdominal aortic aneurysms this minimally invasive technology is hampered in China. In order to reduce the cost, it is necessary to make the stents domestic, but the evidence-based medical data of domestic stents for abdominal aortic aneurysms are still scarce. Aim: to compare the effect of endovascular repair of abdominal aortic aneurysm with (GORE EXCLUDER) stent. Methods: the clinical data of 32 patients with subrenal abdominal aortic aneurysm underwent endovascular repair from January to November 2014 in vascular surgery, affiliated hospital of Qingdao University, were retrospectively analyzed. GORE EXCLUDER covered stent in 21 cases. All the patients were male, aged 56-79 years (mean (70.2 卤6.9) years). Aortic computed tomography angiography was performed at the 1st, 6th month and every 6 months after operation to evaluate the therapeutic effect. Results and conclusion: (1) in the domestic stent group, 11 cases were successfully implanted with Huametaike stent. Delayed type 鈪，

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