血管缝合器在经皮行主动脉腔内修复术应用中的早期经验Preliminary experiences with PercloseTM devices during percutaneous endovascular aortic repair
罗建方,黄文晖,刘媛,倪忠涵,薛凌,范瑞新,周颖玲,陈纪言
摘要(Abstract):
目的评估在股动脉穿刺部位采用预先缝合技术实施经皮主动脉腔内修复术的可行性、安全性和有效性。方法 2009年10月到11月,共有9名主动脉瘤或夹层患者的11处股动脉穿刺部位接受这种技术管理,术前根据CTA和彩色超声检查证实股动脉入路解剖适合此种术式。造影、麻醉与覆膜支架置入按照标准方法进行,覆膜支架系统包括ZenithTX2(Cook,美国)4例,Valiant(Medtronic,美国)3例,Hercules(Microport,中国)2例,对术后所有患者进行生命体征、穿刺部位、同侧下肢血运的密切观察。结果患者包括5例DebakeyⅢ夹层,3例腹主动脉瘤和1例弓降部胸主动脉瘤,年龄为(61.2±11.6)岁(男性例7例);9例患者全患有高血压病;5例患有冠心病;3例有糖尿病。器械外径有16Fr2例,20Fr2例,22Fr3例,24Fr4例;9处穿刺口使用2套PerclosePro-GlideTM(Abbott,美国)血管缝合器,另2处使用3套,技术成功率为100%;无围术期的血管并发症发生。结论在实施主动脉腔内修复术中,使用经皮穿刺、预先PercloseProGlideTM缝合器缝合穿刺口的技术,是替代股动脉切开安全可行的方法 。
关键词(KeyWords): 主动脉腔内修复术;经皮穿刺;预先缝合
基金项目(Foundation):
作者(Author): 罗建方,黄文晖,刘媛,倪忠涵,薛凌,范瑞新,周颖玲,陈纪言
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