Combined internal and external blood shunt technologies for the in-situ three-fenestration revascularization of aortic arch
10.3760/cma.j.issn.1007-631X.2020.02.008
- VernacularTitle:内转流结合外转流技术在主动脉弓部原位三开窗术中的应用
- Author:
Zhao LIU
1
;
Wenwen WANG
;
Yuelin ZHU
;
Tong YU
;
Xin ZHANG
;
Chen LIU
;
Min ZHOU
;
Changjian LIU
;
Xiaoqiang LU
Author Information
1. 南京大学医学院附属鼓楼医院血管外科 210008
- Keywords:
Aortic diseases;
Stents;
Brain protection;
Shunt
- From:
Chinese Journal of General Surgery
2020;35(2):116-119
- CountryChina
- Language:Chinese
-
Abstract:
Objective To summarize the brain protection application experiences of combined internal and external blood shunt technologies for the in-situ three-fenestration revascularization of aortic arch.Methods From Feb 2017 to Jun 2018,8 patients with aortic arch leisons were treated by the in-situ three-fenestration techniques,including 3 aortic dissection,2 aortic aneurysm,3 postoperative TEVAR patients.We adopt the method of internal and external blood shunt technologies for brain protection using the vascular sheath for fenestration combined with carotid shunt tube skills,and using TCD to monitor the blood flow of brain.Results All operations completed successfully,and TCD showed no significant cerebral ischemia when aortic stent was used to cover the three branches of the aorta.The mean time of brain protection was (17.62 ± 6.87) minutes.One patient developed transient cerebral ischemia after surgery,and another one developed cerebral infarction.Conclusions The brain protection strategy of internal bypass combined with external converter technology maintain the brain blood flow,while is simple and feasible,it cannot completely avoid neurological complications.
