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find Author "胡桓睿" 2 results
  • 血管腔内超声联合药涂球囊、药涂支架治疗下肢动脉硬化闭塞症的疗效

    目的总结IVUS联合药涂球囊、药涂支架治疗1例下肢动脉硬化闭塞症的体会。方法回顾性分析笔者所在医院于2025年3月收治的1例接受血管腔内超声(intravascular ultrasound,IVUS)联合药涂球囊、药涂支架治疗的下肢动脉硬化闭塞症患者的临床资料。结果患者为老年女性,主要表现为下肢间歇性跛行,下肢CT血管成像检查示右侧股浅动脉节段性显影,管腔内血栓形成,管腔重度狭窄/次全闭塞可能。综合患者临床表现、下肢血管解剖条件,最终采用联合IVUS行右侧股浅动脉药涂球囊扩张、药涂支架植入术。术前IVUS发现患者血管壁斑块负荷较轻,故未行减容处理、先行单纯球囊扩张术;术中通过IVUS证实导丝全程位于真腔,精准识别球囊扩张后右侧股浅动脉近端及远端的夹层类型,并根据限流性、非限流性夹层分别予以药涂支架植入和药涂球囊扩张;术后采用IVUS客观、准确地评估支架完全覆盖狭窄及夹层病变,形态良好、贴壁良好,未见残余狭窄病变。手术时间为95 min,术中出血约5 mL,围手术期无明显并发症,术后2 d正常出院。随访期间患者右下肢跛行症状明显缓解,术后1个月复查血管彩超示植入血管支架血流通畅,继续随访。结论IVUS能对下肢动脉硬化闭塞症腔内治疗进行准确且直观的术前预评估、术中评估和术后评估,为其围手术期治疗策略制定提供良好的临床指导,从而利于改善患者预后。

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  • Single-center experience with hybrid surgery for thoracoabdominal aortic aneurysm in West China Hospital

    ObjectiveTo explore the efficacy and safety of hybrid surgery in the treatment of thoracoabdominal aortic aneurysm (TAAA). MethodsTwenty patients who were diagnosed with TAAA (including chronic thoracoabdominal aortic dissection aneurysm) and underwent hybrid surgery in Vascular Surgery, West China Hospital, Sichuan University were enrolled between January 2015 and December 2022. All the patients underwent retrograde reconstruction for visceral arteries in the open surgery. Additionally, one-stage or two-stage endovascular aortic repair with covered stents was performed. The patients’ clinical baseline information was collected. Moreover, the patients received clinical follow-up and imaging examinations postoperatively, whose informationwas collected. ResultsOne patient developed paraplegia and acute renal failure 16 days postoperatively in the hospital, and subsequently died in the hospital due to septic shock. Another patient underwent exploratory laparotomy for hemostasis due to anastomotic bleeding in the hospital. The other patients did not experience serious complications perioperatively. Nineteen patients were discharged from the hospital with long-term follow-up ranging from 10 to 144 months (median time: 48 months), and all of them had a long-term survival. No patients were observed with paraplegia, myocardial infarction, stroke, or rupture of aneurysm. None of the patients received reintervention during the follow-up, except for one patient who underwent ultrasound-guided puncture and suctionin the aneurysmallumen. ConclusionHybrid surgery is an effective treatment for TAAA with favorable short- and long-term safety and efficacy.

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