Author/Editor     Ključevšek, Tomaž; Šurlan, Miloš; Berden, Pavel; Klančar, Janez
Title     Endoproteze v perifernih arterijah
Translated title     Endoprostheses in peripherial arteries
Type     članek
Source     Med Razgl
Vol. and No.     Letnik 38, št. Suppl 3
Publication year     1999
Volume     str. 92-7
Language     slo
Abstract     Until now, a lot of studies have been published which offer the hope that peripheral aneurysms may eventually be treated percutaneusly. In addition, stent grafts might also be used in ruptured aneurysms, arteriovenous fistulas, traumatised arterial lesions, long occlusions, long dissections and in some cases of ulcrated lesions, to prevent distal embolisation. Endoluminal grafting is an alternative approach to conventional surgical repair. The objective of this new technique is to be less invasive, avoiding the need for incision, general anaesthesia and transfusion. This concept was initially proposed by Dotter and in 1985, Cragg et al. reported the first percutanous grafting technique with a nitional stent. At our institution, from January 1997 to December 1998, seven patients were treated with Passager stent-graft implantation. In six cases the procedure was urgent (three arterial ruptures during PTA, rupture of internal iliac artery aneurysm, haemorrhage from axillary and subclavian artery at the puncture site). The seventh case was planed a treatment of a popliteal aneurysm. Endovascular grafts were successfully placed in all seven patients. One patient died two days later of consequences of irreversible shock. The rest of them were clinically stable and no additional surgical treatment was needed. Our experiences with long occlusive lesions of femoropopliteal segment are not good. Six Cragg Endopro System grafts were placed and all patients had early thromboses.
Summary     Zadnja leta je bilo objavljenih veliko študij, ki kažejo, da lahko periferne anevrizme uspešno zdravimo perkutano s vstavitvijo endoprotez. Uporabljajo se tudi pri zdravljenju razpočenih anevrizem, arterio-venskih fistul, poškodb arterij, dolgotrajnih zapor, dolgih disekcij in razjed arterij za preprečitev distalnih embolizacij. Perkutano vstavljanje endoprotez je alternativa klasičnemu kirurškemu pristopu. Prednosti te tehnike so manjša invazivnost, manjša izguba krvi, poseg je izvedljiv v lokalni anesteziji. Prvo pokrito nitinolovo opornico je leta 1985 vstavil Cragg. V naši ustanovi smo od januarja 1997 do decembra 1998 z vstavitvijo endoproteze Passager zdravili sedem bolnikov. Pri šestih bolnikih je šlo za urgenten poseg (tri razpočenja medeničnih arterij med perkutano transluminalno angiopalstiko, krvavitev iz razpočene anevrizme notranje medenične arterije, krvavitvi na punkcijskem mestu iz podključnice in pazdušne arterije). Le pri enem bolniku je bil poseg načrtovan. Tehnično je bil poseg uspešen v 100%. Bolnik s krvavitvijo iz podključnične arterije je umrl dva dni po posegu zaradi multiorganske odpovedi, ki je bila posledica neprovratne faze hemoragičnega šoka. Pri ostalih je bil poseg tudi klinično uspešen. Z vstavitvijo Craggove endoproteze smo zdravili tudi šest bolnikov z ishemijo spodnjih udov, vendar so bili naši rezultati slabi.
Descriptors     PERIPHERAL VASCULAR DISEASES
BLOOD VESSEL PROSTHESIS
ANGIOPLASTY
ARTERIAL OCCLUSIVE DISEASES