| Wth the boosting development of economy in our country, and the improvement of theliving standard, the series diseases in vascular system that based on the hypertension, diabetesand arteriosclerosis has been the essential thIeatening to the health and live of the people. Theincidence of arterous stenostic and dilative diseases in aorta, cervix, viscera, and peripheralarteries, such as arteriosc1eroobliterans, abdominal aortic aneurysms (AAA), and aorticdissections (AD), are increasing steadily. Though the dilative artery diseases are notmalignani tuors, with the coniinuous1y enlargemeni of the sac, the degeneratived sac willruPture at last, and resulting the life thIeatening bleeding that usually cause death. Overthinety-percent sudden deaths of AAA patients were due to the sac ruPture. 1n America, thedeath ratio due to AAA rupture lines to thirteen among all the causes that leading to death.Aboul fifty thousand patienis need surgical treatment every year. In China, Feng Youxiancollected the matCrial of auopsy on the people over sixty years old, and found the incidenceof AAA is 2%. Based on the population of l .3 billion in our country, that was a huge quanity,even most of them were die of other reasons. Furthermore, many cities in our country hasactually came into the aged society. In the near future, the Whole nation is also will be so,Which is similar to the developed coul1tries. It is predictable that the incidence of arterousdilative diseases as AAA and AD wil1 increase yearly. All the series of problems are notsensitive to medication, While the on1y managemel1t is surgery. Conseclltive method of thetreatment is to resect the lesions, and a segmeni of anificial vessel is inserted to replace it. BUtthe most patiellts with these series of disease are aged. Arteriosclerosis, diabetes,hyperlepoemia, hypertension and heart, lung, kidney, cerebrum insufficiency are oftenaccomPanied with them, Which may reduce the tolerance to the surgery sharply. Besides, thelesion vessels are usually hidden deeply in the body, Where the anatomical condition is verycomPlex. Thus the trauma of the conventional surgery is sevef, and time of operation is long,the blood transfusion volume is large, the complications are excessive, the resuming time islong, and thus the postoperative death ratio is relatively high. This made the patients difficultto make a choice between the high risk of surgery and waiting under the threatening of theruPture.In the nearly decades, with the desiring of high quality life and the changing medicalpattern, the trends of surgery began directing to simple intervention and mini-traumatic. Forthe dilative arterous diseases, a novel mini-invasive endovascular theraPy emerged. Thestent-grafts are delivered intraluminaly to exclude t11e lesions out of the normal circulation.Thus the technique is nominated as endovascular exclusion (EVE). It has the advanages ofmini-traumatic, less blood transfusion, raPid resumption, less complication.ln China, Jing Zaiping and colleagues firstly aPplicated the tecbnique from 1999. Theauthor joined the working team luckily from then on. In the course of aPplicating of oversea'sdevices, it was aPpeared that the price is too high to most of the patients, and the waiting timefOr the aPpropriate devices was too long. Additionally, among the commercially availabledevices, the sizes and configurations not always match to the needs of the cases in our coufltry.For instance, patienis often come to the hospital for tfeatment comparatively late. The AAAextends compaxatively larger, and anatomical configurations of the neck and the channelvessels are not satisfying. For the incidence of AD, it seams that it is higher than that in thetwest coulltries. And recently, we constamly faced to the comp1icated AD cases that could notbe categorized with Stanford or Debakey method. A matter is that the commercial availabledevices designed specially for the AD is not much...
|
PDF Full Text Request