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目的评价新型覆膜Cheatham-Platinum(CP)支架置入治疗青少年或成人主动脉缩窄(CoA)的近期疗效。方法2005年8月至2006年6月,共完成8例CoA覆膜CP支架置入术。根据CT和DSA检查选择支架的型号及球囊的大小;经股动脉穿刺送入装载有支架的球囊导管,准确定位后充盈内外球囊,扩张覆膜支架。术后应用血管闭合器缝合局部穿刺点。结果覆膜CP支架均顺利置入。跨缩窄段平均收缩压差明显下降,术前为(63.8±17.6)mm Hg(1mm Hg=0.133kPa),除1例由术前77mm Hg降至35mm Hg外,余者均降至5mm Hg以下,主动脉最窄处直径由术前(4.8±1.4)mm增加至(18.0±2.6)mm。除1例主动脉弓发育不良外,余者上下肢血压均恢复正常。合并动脉导管未闭的患者,分流完全消失。随访1～8个月,临床症状均明显缓解,超声多普勒或CT增强扫描示缩窄端管径明显改善。结论新型覆膜CP支架置入治疗CoA,近期效果满意,中远期疗效有待于进一步观察。
Objective To evaluate the short-term curative effect of Cheatham-Platinum (CP) stents for the treatment of adolescent or adult aortic constriction (CoA). Methods From August 2005 to June 2006, a total of 8 cases of CoA-covered CP stenting were completed. According to CT and DSA examination select the type of stent and the size of the balloon; the femoral artery puncture into the stent-loaded balloon catheter, accurate positioning after filling the balloon inside and outside, stent expansion stent. Postoperative vascular closure suture local puncture point. Results The covered stent was placed smoothly. The mean systolic pressure drop across the narrowing segment was significantly decreased, preoperatively (63.8 ± 17.6) mm Hg (1 mm Hg = 0.133 kPa), except for 1 patient falling from 77 mm Hg to 35 mm Hg before surgery, with the remainder dropping to 5 mm Hg The diameter of the narrowest aorta increased from (4.8 ± 1.4) mm to (18.0 ± 2.6) mm preoperatively. Except one case of aortic arch dysplasia, the upper and lower limbs blood pressure returned to normal. In patients with patent ductus arteriosus, the shunt disappeared completely. All cases were followed up for 1 to 8 months, and the clinical symptoms were relieved. Ultrasound Doppler or enhanced CT showed that the diameter of the narrowed end was significantly improved. Conclusions The new type of stent covered with stenting for the treatment of CoA, the recent satisfactory results in the long-term efficacy remains to be further observed.