“一站式”腔内治疗冠心病合并主动脉粥样硬化性疾病的探讨

被引:2
作者
罗明尧 [1 ]
唐熠达 [1 ]
方坤 [1 ]
陈祖君 [1 ]
陈雷 [1 ]
吕滨 [1 ]
常谦 [1 ]
孙晓刚 [1 ]
欧阳晨曦 [1 ]
舒畅 [1 ,2 ]
机构
[1] 中国医学科学院北京协和医学院国家心血管病中心阜外医院心血管疾病国家重点实验室
[2] 中南大学湘雅二医院血管外科
关键词
动脉硬化; 主动脉; 冠心病; 血管内操作;
D O I
暂无
中图分类号
R654 [心脏血管和淋巴系外科学];
学科分类号
100408 [卫生政策与卫生管理学];
摘要
目的:探讨冠状动脉介入治疗(PCI)联合主动脉腔内修复术(EVAR)"一站式"治疗冠心病和主动脉粥样硬化性疾病的临床策略及其安全性。方法:回顾性分析2016年1月—2016年6月中国医学科学院阜外医院行腔内治疗的7例合并冠心病的主动脉粥样硬化性疾病患者资料,其中男6例,女1例,平均年龄76.2(64~86)岁,术前主动脉CT和冠脉CT确诊主动脉病变和冠脉病变并存,术中造影确认主动脉和冠脉病变均符合介入治疗指征后,实施"一站式"手术治疗。结果:手术成功率100%,无围术期死亡。术后并发症包括切口附近皮下瘀斑2例,其中合并血肿1例,后者因血色素下降予以输注浓缩红细胞2 U治疗。1例主动脉弓降部溃疡患者以烟囱技术重建左锁骨下动脉,其左侧肱动脉穿刺点出现假性动脉瘤,予以外科修复。所有患者均获得门诊或电话随访,随访时间7(6~10)个月,所有患者临床症状消失或明显减轻,生活质量改善,无再次手术或死亡。结论:PCI联合EVAR"一站式"治疗冠心病和主动脉粥样硬化性疾病早中期疗效满意,切口或穿刺部位出血性并发症应予警惕。术后药物治疗方案严格按照冠心病的治疗原则进行。
引用
收藏
页码:1683 / 1688
页数:6
相关论文
共 11 条
[1]
胸主动脉腔内修复术中封堵左锁骨下动脉的安全性研究 [J].
舒畅 ;
王沙龙 ;
姜晓华 ;
李全明 ;
黎明 ;
李鑫 .
中国普通外科杂志, 2014, 23 (12) :1614-1619
[2]
Outcomes of Thoracic Endovascular Aortic Repair and Subclavian Revascularization Techniques [J].
Zamor, Kimberly C. ;
Eskandari, Mark K. ;
Rodriguez, Heron E. ;
Ho, Karen J. ;
Morasch, Mark D. ;
Hoel, Andrew W. .
JOURNAL OF THE AMERICAN COLLEGE OF SURGEONS, 2015, 221 (01) :93-100
[3]
Combined Coronary Artery Bypass Grafting and Abdominal Aortic Aneurysm Repair: Presentation of 3 Cases and a Review of the Literature.[J].Andrew M. Williams;Jennifer Watson;M. Ashraf Mansour;George T. Sugiyama.Annals of Vascular Surgery.2016,
[4]
Endovascular Aortic Repair Combined with Chimney Technique in the Treatment of Stanford Type B Aortic Dissection Involving Aortic Arch [J].
Liu, Hong ;
Shu, Chang ;
Li, Xin ;
Wang, Tun ;
Li, Ming ;
Li, Quan-Ming ;
Fang, Kun ;
Wang, Shalong .
ANNALS OF VASCULAR SURGERY, 2015, 29 (04) :758-763
[5]
Early endovascular aneurysm repair after percutaneous coronary interventions [J].
Pecoraro, Felice ;
Wilhelm, Markus ;
Kaufmann, Angela R. ;
Bettex, Dominique ;
Maier, Willibald ;
Mayer, Dieter ;
Veith, Frank J. ;
Lachat, Mario .
JOURNAL OF VASCULAR SURGERY, 2015, 61 (05) :1146-1150
[6]
Technical Strategy in a Patient with Symptomatic Thoracic Aneurysm Near the Origin of the Left Subclavian Artery and Left Internal Thoracic Artery Coronary Graft [J].
Babic, Srdjan D. ;
Radak, Djordje J. ;
Sotirovic, Vuk A. ;
Unic-Stojanovic, Dragana R. ;
Babic, Dusan S. ;
Popov, Petar Z. ;
Sagic, Dragan Z. .
JOURNAL OF CARDIAC SURGERY, 2012, 27 (06) :725-727
[7]
A Combination of Aortic Arch Debranching and Off-Pump Coronary Artery Bypass [J].
Hiraoka, Arudo ;
Yoshitaka, Hidenori ;
Chikazawa, Genta ;
Totsugawa, Toshinori ;
Kuinose, Masahiko .
JOURNAL OF CARDIAC SURGERY, 2012, 27 (04) :518-520
[8]
A new approach to percutaneous coronary revascularization in patients requiring undeferrable non-cardiac surgery.[J].Federico Piscione;Salvatore Cassese;Gennaro Galasso;Plinio Cirillo;Giovanni Esposito;Antonio Rapacciuolo;Dario Leosco;Raffaele Piccolo;Roberta De Rosa;Massimo Chiariello.International Journal of Cardiology.2009, 3
[9]
Combined abdominal aortic aneurysm repair and coronary artery bypass:: Presentation of 13 cases and review of the literature [J].
Wolff, T ;
Baykut, D ;
Zerkowski, HR ;
Stierli, P ;
Gürke, L .
ANNALS OF VASCULAR SURGERY, 2006, 20 (01) :23-29
[10]
Repair of large abdominal aortic aneurysm should be performed early after coronary artery bypass surgery [J].
Paty, PSK ;
Darling, RC ;
Chang, BB ;
Lloyd, WE ;
Kreienberg, PB ;
Shah, DM .
JOURNAL OF VASCULAR SURGERY, 2000, 31 (02) :253-257