■这项研究是为了找出可行性,功效,单分支支架移植物的安全性,即蓖麻,在主动脉弓病变伴有异常锁骨下动脉(ASA)和/或Kommerel憩室(KD)的情况下,结合开窗或烟囱。
■对2018年6月至2023年6月接受Castor的所有主动脉弓病变和ASA和/或KD的连续患者进行了调查。
■纳入18名患者,该研究包括11例KD,3例吞咽困难;2例右侧主动脉弓伴左侧锁骨下动脉(ALSA),左侧主动脉弓伴右侧迷走右锁骨下动脉(ARSA)16例。平均手术时间为132±23分钟。平均测量的近端主动脉直径为30.9±1.6mm,Castor支架的近端直径为34(32,34.5)mm,超大面积为9.1±1.6%;平均测量的分支直径为8.8±0.97毫米,Castor支架的分支直径为10(8,10)mm,尺寸为0.86±0.57mm。技术成功率100%,没有住院死亡率,没有中风,没有发现内漏。发现1例(5.6%)脊髓缺血和1例(5.6%)手术部位愈合不良。在后续期间,无主动脉相关死亡或二次干预记录.最大主动脉直径在术后第六个月(padj=0.031)显着减小;KD直径在术后第三个月(padj=0.001)和第六个月(padj<0.001)显着减小。
■通过Castor支架与开窗或烟囱结合使用ASA和KD对主动脉弓病变进行完全腔内修复是可行的,有效,和安全,可以实现令人鼓舞的中期结果,并在病变处提供出色的重塑。
结论:单分支支架与开窗或烟囱结合实现了足够的近端着陆区,并在这项回顾性研究中提供了令人鼓舞的中期结果,对18例接受病理性主动脉弓血管内治疗并伴有异常锁骨下动脉和/或Kommerell憩室的患者进行了回顾性研究。作者提出了这种省时高效的技术,为这类患者的治疗建立系统的经验。
UNASSIGNED: The study was to figure out the feasibility, efficacy, and safety of a single-branched stent graft, namely Castor, in combination with fenestration or chimney in the context of aortic arch lesions presenting with aberrant subclavian artery (ASA) and/or Kommerell\'s diverticulum (KD).
UNASSIGNED: All consecutive patients with aortic arch lesions and ASA and/or KD receiving Castor from June 2018 to June 2023 were investigated.
UNASSIGNED: Incorporating 18 patients, the study encompassed 11 cases with KD, 3 cases with dysphagia; 2 cases of right-sided aortic arch with left-sided aberrant left subclavian artery (ALSA), and 16 cases of left-sided aortic arch with right-sided aberrant right subclavian artery (ARSA). The mean operation time was 132±23 minutes. The mean measured proximal aortic diameter was 30.9±1.6 mm, and proximal diameter of Castor stent was 34 (32, 34.5) mm, with oversize of 9.1±1.6%; the mean measured branch diameter was 8.8±0.97 mm, and branch diameter of Castor stent was 10 (8, 10) mm, with oversize of 0.86±0.57 mm. Technical success rate was 100%, and no in-hospital mortality, no stroke, and no endoleak were identified. One (5.6%) case with spinal cord ischemia and one (5.6%) case with poor healing of operative site were identified. During the follow-up period, no aortic-related death or secondary intervention was recorded. The maximal aortic diameter was significantly reduced at the sixth postoperative month (padj=0.031); KD diameter was significantly reduced at the third (padj=0.001) and sixth (padj<0.001) postoperative month.
UNASSIGNED: Totally endovascular repair of aortic arch lesions with ASA and KD via Castor stent in combination with fenestration or chimney is feasible, effective, and safe, which can achieve an encouraging medium-term outcome and provide excellent remodeling at the lesions.
CONCLUSIONS: Single branched stent in combination with fenestration or chimney achieved a sufficient proximal landing zone and provided an encouraging medium-term outcome in this retrospective review of 18 patients receiving endovascular treatment of pathological aortic arch with aberrant subclavian artery and/or Kommerell\'s diverticulum. The authors suggest this time-saving and efficient technique to establish systematic experience for the treatment in this kind of patients.