目的：初步探讨体外开窗EVAR技术治疗短瘤颈腹主动脉瘤（abdominal aortic aneurysm，AAA）的可行性。方法回顾性分析2013年8月至2016年8月天津医科大学总医院血管外科收治的6例应用体外开窗技术治疗的短瘤颈AAA患者的临床资料。所有患者均根据术前计算机体层摄影血管造影（computed tomography angiography，CTA）数据预定或者自制体外开窗支架，行AAA腔内修复术（endovascular aortic repair，EVAR）和内脏动脉分支支架植入术。结果6例均顺利完成手术。2例患者术后1周内出现一过性肾功能损伤，经内科治疗后改善。6例患者平均随访时间为8.6个月（范围为1～24个月）。1例左侧肾切除患者术后3个月复查彩色超声多普勒，显示右侧肾动脉通畅，腹主动脉支架通畅，无内漏。其余5例患者术后复查C TA ，均显示主体开窗支架和内脏分支支架通畅，无内漏。结论体外开窗EVAR技术是一项治疗短瘤颈AAA的可行方法。%ObjectiveTo investigate the clinical value of Fenestrated EVAR for treating abdominal aortic aneurysm with short proximal neck.Methods A retrospective analysis of the result 6 cases from August 2013 to August 2016 was performed. Fenestrated stent-grafts were designed according to the preoperative CTA data. All cases underwent EVAR with the fenestrated stent-grafts to revascularize visceral branches.Results Fenestrated EVAR was performed in all of the 6 cases successfully. Renal dysfunction occurred in two cases during 7 post-operative days and improved with the medical treatment. Mean follow-up period was 8.6 months (range, 1-24 months). The Doppler of one case with nephrectomy on the left side at 3 months follow-up showed patency and no endoleak of both fenestrated stent graft and right renal stent graft. CTA was performed among other 3 cases postoperatively. Patency and no endoleak of fenestrated stent graft and visceral stent grafts were found from the images.Conclusion Fenestrated EVAR is a viable and safe alternative to treat AAA with short proximal neck.
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