경관적 Stent-graft 삽입술을 이용한 대동맥류의 치료

Abstract

Purpose : The standard treatment for aortic aneurysms is surgical replacement with a prosthetic graft.Currently there is great interest in endoluminal intervention for treatment of aortic aneurysm. The purpose ofthis study was to evaluate the safety and effectiveness of a endoluminally placed Stent-graft for the treatment ofaortic aneurysms. Materials and Methods : Transluminal endovascular Stent-graft placements were attempted in 9patients with infra-renal aortic aneurysms(n=6), thoracic aortic aneurysm(n=1), and aortic dissection(n=2). Theendovascular Stent-grafts were custom-designed for each patient and were constructed of self-expandable modifiedGianturco Stents covered with polytetrafluroethylene. The Stent-grafts were introduced through a 16-18 frenchsheath and expanded to 17-30mm in diameter. The endovascular therapy was performed using a common femoral arterycutdown with local anesthesia. Results : The endovascular Stent-graft deployment were achieved in 7 of 9 patients.Two cases failed deployment of the Stent-graft due to iliac artery stenosis and tortousity. There was completethrombosis of the thoracic and infra-renal aortic aneurysm surround the Stent-graft in 3 patients, and apersistent leak with partial thrombosis in 2. Two patients with aortic dissection were successfully treated byobliteration of entry tears. There were no major complication associated with Stent-graft placement. Conclusion :These preliminary results shows that transluminal endovascular Stent-grafts offers great promise and good results.Further investigation is needed to establish its long-term safety and efficacy.