心脉视野CEC

Size: px

Start display at page:

Download "心脉视野CEC"

镡玫渊空
7 years ago
Views:

1 临床进展微创Castor分支型主动脉覆膜支架临床试验进展先锋学术陈忠腔内技术与主股动脉转流治疗TASC C D型主髂动脉病变的远期通畅率结果郭伟急性Stanford B型主动脉壁间血肿患者近中期随访结果及CT形态变化符伟国应用主动脉夹层隔膜穿刺破膜技术治疗覆膜支架误置入夹层假腔行业新知总第8期 2013/CEC Horizon

3 Castor 分支型主动脉覆膜支架临床试验进展临床进展 2013 年 4 月 8 日, 微创心脉医疗科技 ( 上海 ) 有限公司 Castor 分支型主动脉覆膜支架及输送系统 ( 以下简称 Castor 覆膜支架 ) 成功完成第一例临床植入以来, 截止到今日, 已在全国 10 个中心顺利完成了 42 例临床试验总共计划进行 70 例临床试验 7 月 11 日,Castor 覆膜支架首次在首都医科大学附属北京安贞医院, 由陈忠教授带领团队成功开始第一例临床试验患者男性,65 岁, 术前造影见 ( 图 1 2, 测量左颈总动脉开口处直径约为 27.9mm, 左锁骨下动脉开口处直径约为 26.4mm, 破口距离左颈总动脉的距离约为 16.9mm 支架置入过程顺利, 术后再次行主动脉弓部造影, 左侧锁骨下动脉血流通畅, 夹层被完全隔绝 ( 图 3) 目前, 北京安贞医院分别由陈忠教授和黄连军教授带领团队共进行了 2 例临床试验, 中国图 1 2 术前造影测量人民解放军总医院郭伟教授和团队完成 1 例, 复旦大学附属中山医院符伟国教授完成 7 例 Castor 覆膜支架临床试验, 均获得了满意的疗效在上海中山医院的临床中还有一例患者为马凡综合征, 男性,24 岁, 因持续胸背部疼痛 6 天入院,04 年至今右侧视网膜反复脱落术前造影显示主动脉夹层破口距离左锁骨下动脉较近 ( 图 4), 选择 C 支架, 按步骤置入体内后, 支架定位准确, 左颈总动脉无覆盖, 夹层隔绝满意 ( 图 5) Castor 覆膜支架临床试验是世界上首次分支胸图 4 马凡患者夹层术前造影主动脉覆膜支架的大规模前瞻性多中心的正式临床研究, 也是国家 863 十二五规划重大课题今明两年, 微创心脉还有一系列具有国际先进水平的产品进入国内外临床试验阶段图 5 术后破口完全覆盖, 效果良好图 3 术后假腔不显影, 分支通畅 Endovascular Horizon 总第 8 期 1

4 先锋学术摘录 : 腔内技术与主股动脉转流治疗 TASC C D 型主髂动脉病变的远期通畅率结果杨燎吴庆华陈忠唐小斌寇镭吴章敏刘晖王盛杨耀国贾云峰张征何楠心肺血管病杂志 2013 年 1 月第 32 卷第 1 期摘录 : 急性 Stanford B 型主动脉壁间血肿患者近中期随访结果及 CT 形态变化唐兴奎熊江许永乐郭伟郭兢津梁伟雄中华医学杂志 2013 年 3 月 5 日第 93 卷第 9 期 Endovascular Horizon 总第 8 期 2

5 Endovascular Horizon 总第 8 期 3

6 先锋学术摘录 : 应用主动脉夹层隔膜穿刺破膜技术治疗覆膜支架误置入夹层假腔潘烨赵珺符伟国梅家才邵明哲张健中华创伤杂志 Endovascular Horizon 总第 8 期 4

7 Treatment of Symptomatic Isolated Dissection of Superior Mesenteric Artery Zhihui Dong, MD, Weiguo Fu, MD, Bin Chen, MD, Daqiao Guo, MD, Xin Xu, MD, Yuqi Wang, MD J Vasc Surg Volume 57, Issue 2, Supplement, February 2013, 69S 76S Objective To present the short- to midterm outcomes after management of 14 patients with symptomatic isolated dissection of superior mesenteric artery (SIDSMA) and propose a preliminary treatment algorithm. Background SIDSMA is a rare but potentially fatal entity. However, most of these reports were isolated case reports, and a consensus treatment protocol remains lacking so far. It would be meaningful to propose a reasonable treatment algorithm for it. Endovascular Horizon 总第 8 期 5

8 先锋学术 Methods Patients with SIDSMA who were treated in our center between July 2007 and June 2011 were retrospectively collected and analyzed. Based upon the abdominal pain and signs, the clinical manifestations have been retrospectively classified into grade I (peritonitis absent) and grade II (peritonitis present). Medical treatment mainly included anticoagulation, antiplatelet, and bowel rest. Endovascular stent placement and surgical fenestration with exploratory laparotomy have been selected according to the grade classification. Computed tomographic angiography, magnetic resonance angiography, or duplex scans have been used for diagnosis and follow-up. Results Medical treatment was given for 13 patients of grade I for the first 3 to 5 days after admission, and the abdominal pain remarkably or completely resolved in four patients who received continued medical treatment, whereas the other unresolved nine patients were converted to endovascular stent placement that succeeded in four and failed in five patients. Since these five cases were free from peritoneal signs, medical treatment was given again instead of an immediate surgical intervention, and ultimately achieved complete alleviation of abdominal pain within the following 1 week. The mean duration from the start of medical treatment to the alleviation of symptoms, including the continued medical treatment after the failed endovascular stent placement, was 8 ± 3 days (range, 4-12 days). The grade II patient underwent a successful emergency surgical SMA fenestration without bowel resection. Follow-up was accomplished in all 14 cases, ranging from 2 to 48 months (mean, 30 ± 15 months). No intestinal necrosis, morbidity, or mortality developed during hospitalization. During the follow-up, all patients were free from aneurysmal formation of SMA or chronic intestinal ischemia, and all stents remained patent. Conclusions For grade I SIDSMA, most cases might be successfully treated with medical therapy, and the endovascular stent placement appears to be an acceptable alternative if medical treatment fails. For grade II SIDSMA, the endovascular stenting combined with laparoscopic exploration and/or open surgery could be a reasonable option. Early Malperfusion, Ischemia Reperfusion Injury, and Respiratory Failure in Acute Complicated Type B Aortic Dissection after Thoracic Endovascular Repair Jiang Xiong, Minhong Zhang, Wei Guo, Xiaoping Liu, Tai Yin, Xin Jia, Hongpeng Zhang, Yongle Xu and Lijun Wang Journal of Cardiothoracic Surgery 2013, 8:17 Background: The aim of this study was to determine the early mortality and major complications of acute complicated type B aortic dissection (ACBD) after thoracic endovascular aortic repair (TEVAR). Methods: Twenty-six consecutive patients with ACBD who underwent TEVAR were included. Clinical indications before TEVAR and in-hospital mortality and major complications after TEVAR were analyzed and compared with similar reports. Results: TEVAR was technically successful in all cases. In-hospital mortality occurred in four patients (15%), and major complications occurred in an additional four patients (15%). Three of the four (75%) of the deaths were associated with malperfusion and ischemia reperfusion injury (IRI), and 3/4 (75%) of the major complications were caused by respiratory failure (RF). Conclusions: In-hospital mortality associated strongly with severe end-organ malperfusion and IRI, while major complications associated with RF, during TEVAR. Our results indicate that Endovascular Horizon 总第 8 期 6

9 Endovascular Horizon 总第 8 期 7

10 编辑 : 佘文婕上海微创医疗器械 ( 集团 ) 有限公司地址 : 上海市浦东新区张江高科技园牛顿路 501 号邮编 : 电话 :86(21) 传真 :86(21) 微创心脉医疗科技 ( 上海 ) 有限公司地址 : 上海市南汇时代医创园康新公路 3399 弄 1 号楼邮编 : 电话 :86(21) 传真 :86(21)

心脉视野201311

心脉视野201311 临床进展江苏省人民医院Castor覆膜支架临床试验进展先锋学术烟囱技术用于缺乏锚定区的主动脉弓病变症状性主动脉穿透性溃疡的腔内修复术锚定区不足的主动脉弓夹层及动脉瘤腔内治疗策略行业新知总第7期 2013/11 Horizon 临床进展江苏省人民医院 Castor 覆膜支架临床试验进展 2013 年 4 月 8 日, 微创心脉医疗科技 ( 上海 ) 有限公司 Castor 分支型主动脉覆膜支架及输送系统