开窗与开槽支架患者信息.DOCVIP

PAGE PAGE 5 Fenestrated endovascular aortic repair for juxtarenal abdominal aortic aneurysm: primary clinic experience GUO Wei, ZHANG Hong-peng, LIU Xiao-ping, JIA Xin, XIONG Jiang, Department of Vascular Surgery, Chinese PLA General Hospital, Beijing 100853, China Corresponding author: Dr. GUO Wei, Department of Vascular Surgery, Chinese PLA General Hospital, Keywords: Abdominal aortic aneurysm; Juxtarenal aneurysm; Endovascular aortic repair; Fenestrated stent-graft; Background Endovascular stent-graft with fenestration can improve proximal sealing in patients with juxtarenal abdominal aortic aneurysm (JAAA). The purpose of this study is to describe our primary experience and evaluate the safety and efficacy of fenestrated device for JAAA in high-risk patients. Methods Between March 2011 and May 2012, nine male patients (mean age, 79.6±8.6 years) with asymptomatic JAAAs underwent elective deployment of the Zenith fenestrated stent-grafts at a single institution. All patients were treated in the hybrid operating room under general anesthesia. Follow-up computed tomography angiography (CTA) was routinely performed before discharge, at 3, 6, and 12 months and annually thereafter. Results Procedural success was achieved in all cases. Total sixteen small fenestrations, two large fenestrations and eight scallops were used. Intra-operative complications occurred in 4 patients included: one proximal typeⅠendoleak, two typeⅡendoleaks, and one renal artery dissection. The mean hospital stay was (8.9±1.4) days. Mean blood loss was (360.5±46.8) ml and mean iodinated contrast volume was (230.6±58.3) ml. The mean follow-up time was (7.6±4.2) months. The visceral graft patency was 100% until to now. One patient had an increase of serum creatinine of more than 30%, with not requiring dialysis. No patients died and no stent fracture and migration were diagnosed during the follow-up. Conclusions The early results of fenestrated device for high-risk patients with complex JAAAs