Abstract:

Evaluation and technical keypoints of fenestrated-TEVAR using customer-made or homemade stent graft to revascularize supra-aortic branches        LUO Yu-dong，DAI Xiang-chen.Department of Vascular Surgery, Tianjin Medical University General Hospital, Tianjin 300052, China
Corresponding author：DAI Xiang-chen，E-mail：13302165917@163.com
Abstract    Dilated aortic arch diseases involved supra-aortic branches are difficulties in clinic.It is not available to revascularize supra-aortic branches by traditional TEVAR. Fenestrated-TEVAR using customer-made or homemade stent graft is less-invasive method to revascularize supra-aortic branches, which can overcome the problems by fenestrated-TEVAR in situ.The most difficult point to the technique is how to deploy fenustrated stent graft accurately.Technical success rate can be increased through duplicate-angle evaluation，assisting guide-wire，size-reducing device.

Key words: supra-aortic branches, fenestrated TEVAR, customer-made stent graft, homemade stent graft

摘要：

累及主动脉弓部分支的主动脉扩张性疾病是临床处理的难点。传统的胸主动脉腔内修复术（thoracic endovascular aortic repair，TEVAR）无法进行分支重建，体外预开窗TEVAR技术是重建弓部分支血管的全腔内微创方法。预开窗技术克服了原位开窗技术体内破膜造成的诸多问题，但其面临的最大困难是如何准确定位释放支架。通过多角度切线位判断技术、牵引导丝辅助定位及解缠绕技术、束径带避免分支动脉缺血的半释放技术等措施，可以有效提高预开窗支架释放成功率。

关键词: 弓部分支血管, 开窗TEVAR技术, 定制支架, 自制支架