外周血管的介入治疗新.ppt

* * 通常需要覆盖邻近靶病变的1～2mm动脉段。对于开口病变，最后的支架定位应和主动脉齐平或突入到主动脉内的支架长度2mm。 * * * 2009年2月NICE（National Institute for Health and Clinical Excellence）发布了关于血管腔内支架型血管治疗腹主动脉瘤技术评估指南。 * * Explain which type the patient has; note that saccular aneurysms will most likely need to be treated ASAP, regardless of the size. * Abdominal aortic aneurysms can also be classified according to its position relative to the renal arteries. If the proximal extent of the aneurysm is more than 15 to 20 millimeters below the renal artery, it is considered an infrarenal aortic aneurysm. This type comprises over 90 percent of all abdominal aortic aneurysms. The remaining balance is made up of juxtarenal aortic aneurysms, whose proximal necks are shorter than 15 mm, suprarenal aortic aneurysms, which involve the renal arteries, and thoracoabdominal aortic aneurysms, which involve one or more of the visceral vessels. Up to 20 percent of abdominal aortic aneurysms will present with concomitant iliac aneurysms. In these cases, common iliac aneurysms occur much more frequently than internal iliac artery aneurysms. External iliac aneurysms are extremely uncommon. * Risk factors of abdominal aortic aneurysms are pretty well defined today. It is clearly a disease of the elderly. As previously mentioned, males predominate over females in approximately a 4 to 1 ratio. Family history is also a very strong risk factor: First-degree male relatives harbor up to a 20 percent risk of having an aneurysm. In the last ten to fifteen years, smoking has come to the forefront of acquired risk factors for abdominal aortic aneurysms. A history of greater than 10 pack-years of cigarette smoking is a very significant risk factor for aneurysm development. The presence of peripheral aneurysms – namely, femoral, popliteal, and even thoracic aortic aneurysms -- is a strong risk factor for development of abdominal aortic aneurysms. Beyond these, hypertension and race are also risk factors: Caucasians being far more likely th