主动脉弓复杂病变--HybridChmneyorelse.pptVIP

Different from hybrid operations, the articles about chimney graft include even less number of patients, with majority of paper reporting less than 10 cases. Vasc Surg Dep. Of 301 Hospital Hogendorn et al reported a recent meta-analysis of chimney grafts in TEVAR. Although with a high technical success rate and patency, the endoleak was about 18%. About 1/3 of cases located in Zone 2 area. Vasc Surg Dep. Of 301 Hospital In chimney series, the data above were similar to hybrid papers. Vasc Surg Dep. Of 301 Hospital Compared with hybrid operation, chimney technique is relatively new and total patient number less than 100 cases, median follow-up less than 1 year. Vasc Surg Dep. Of 301 Hospital The major worry of chimney is the endoleak issue. The placement of the chimney graft along the thoracic endograft increases the risk for type I endoleak by creating gutters next to the chimney graft and affecting a good proximal seal. Chimney in Zone 0 and Zone 1 means even more endoleak and complications, which is different for hybrid operation. Vasc Surg Dep. Of 301 Hospital The upcoming branched and fenestrated stent graft intervention has several advantages, such as the minimally invasive insertion and the potentially lower risk for stroke Vasc Surg Dep. Of 301 Hospital Here are some limited articles on fenestrations in TEVAR. The disadvantages include the high costs, higher contrast and radiation use, and that the stent graft must be custom made, which will lead to prolonged waiting time of 4 to 6 weeks. In general, fenestration and branched grafts in TEVAR were still of small sample and in limited centers, there is still a long way from wide use. Vasc Surg Dep. Of 301 Hospital Our preliminary practice of fenestration in TEVAR Vasc Surg Dep. Of 301 Hospital Vasc Surg Dep. Of 301 Hospital CT follow-up Vasc Surg Dep. Of 301 Hospital 主动脉弓复杂病变 －－ Hybrid, Chimney or else? 贾鑫、郭伟 Vascular and Endovascular Surgery Department Chinese PLA General Hospital Endovascular Ch