UCSF健康是血管内手术的先驱, performing more than 150 endovascular aneurysm repairs annually — more than any other medical center on the West Coast. Our team of experts developed and tested groundbreaking endovascular surgical technologies and techniques.
血管内手术
血管内手术是一项创新, less invasive procedure used to treat problems affecting the blood vessels, 比如动脉瘤, which is a swelling or "ballooning" of the blood vessel. The surgery involves making a small incision near each hip to access the blood vessels. 血管内移植, which is a special fabric tube device framed with stainless steel self-expanding stents, 是通过动脉插入的导管吗, 很长一段, 窄柔性管, 位于主动脉内. 一旦就位, 移植物扩张并封闭动脉瘤, 防止血液流入动脉瘤. 移植物会永久地留在主动脉中.
在过去, 这种情况通过开放手术治疗, involving an incision in the side of the chest or breastbone and 很长一段 recovery period. 病人 generally stay in the hospital for seven to 10 days following 开放手术 and undergo a three-month recovery.
一种开放式手术的替代方案, 血管内手术有很多优点, 包括更短的恢复期, 更少的不适, local or regional anesthesia instead of general anesthesia, 小切口, less stress on the heart and fewer risks for patients with other medical conditions. This procedure may benefit patients who need surgery but are at a high-risk of complications because of other conditions.
高级血管内手术
In some cases, standard endovascular repair is not always feasible for patients. Sometimes the aneurysm is too close to important branches of the aorta or the arteries are too narrow or too complicated to permit passage of the catheter used in endovascular surgery. 在这些情况下, 病人有三个选择:不治疗, 开放手术, 或者复杂的血管内修复.
血管外科十大赌博平台排行榜s at 加州大学旧金山分校健康 have developed new procedures and technologies, 哪些是其他医疗中心没有的, 在复杂情况下使用血管内技术. These advanced techniques may be used for thoracoabdominal aortic aneurysms (TAAA), 包括通往腹部器官的重要动脉吗, 或者是主动脉瘤, 包括通往大脑的重要动脉的.
准备
血管内手术前, you will meet with your doctor who will take your medical history and conduct a thorough physical exam. You also may have tests to determine the health of your heart, 比如压力测试和心电图, 记录心脏电活动的仪器.
To determine whether your aneurysm can be treated with endovascular surgery, 你会有测试, 包括CT扫描和血管造影, which allow your doctor to view your aorta and blood vessels. These tests also allow the doctor to select the appropriate size graft.
在此期间, your doctor will discuss endovascular surgery with you, 回答你们的任何问题.
继续阅读
过程
在手术开始之前, you will have either a sedative and regional anesthesia to make you more comfortable and numb the area of operation, or general anesthesia that will put you to sleep completely. The area of insertion will be cleaned and shaven to prevent infections. Your doctor will make a small incision around the hip, 靠近臀部和大腿之间的折痕处, 进入你的血管. A guide wire is inserted through the incision and a pushed through a blood vessel to the aneurysm.
Special X-rays will be taken so your doctor can see the exact location of the aneurysm. At that point, he or she will insert a catheter — 很长一段, flexible narrow tube – over the guide wire. The catheter is used to carry the graft through your blood vessels to the aorta above the aneurysm. 一旦就位, 移植物从导管中释放并扩张, 阻碍了血液流向动脉瘤, 哪一种会使动脉瘤随着时间缩小.
在程序完成之前, X-rays will be taken to confirm that blood in the aorta is flowing through the graft, 不是通过动脉瘤. The incisions near your hip will then be closed with sutures.
复苏
After surgery, you will be closely monitored and cared for by our team of experts. Most patients spend two to three days in the hospital. The first day following surgery you will be allowed to walk and to eat. 然而, most patients experience feelings of reduced energy and appetite for approximately two weeks after the operation.
当你能回家的时候, 你可以用海绵洗澡, but should not soak the area around your incision until it has completely healed. Most patients are able to return to their normal activities within four to six weeks after surgery.
跟进
手术后一到两周, you will have a follow-up appointment with your doctor to check the progress of your recovery. 手术后1个月和6个月, you will have imaging tests to be sure that your graft is functioning properly. After the first year, you will have annual imaging tests to check your aneurysm and graft.
并发症
As with any procedure, endovascular surgery does have potential complications, which may include:
- 血液在移植物中的流动被阻塞
- Fever and an increase in white blood cell count shortly after the surgery
- 贪污压裂
- 感染
- 移植物周围出血
- Movement of the graft away from the targeted position
Other complications that are rare, but serious may include:
- 血液流向腹部或下半身受阻
- 动脉破裂
- 动脉瘤延迟破裂
- 肾脏损伤
- 麻痹
加州大学旧金山分校健康 medical specialists have reviewed this information. It is for educational purposes only and is not intended to replace the advice of your doctor or other health care provider. We encourage you to discuss any questions or concerns you may have with your provider.
