《血管与腔内血管外科杂志》223年4月第9卷第4期Joumal of Vascular and Endovascular Surgery Vol.9,No.4.Apr 2023·专家共识·胸腹主动脉瘤内脏动脉分支重建专家共识中国微循环学会周围血管疾病专业委员会摘要：胸腹主动脉瘤(TAAA)累及重要内脏动脉分支的患者病变复杂，腔外或腔内的修复术是其主要治疗方式，随着技术的不断更新迭代，两种治疗方式的适应证不断拓宽，但目前相应的技术及材料仍未普及，复杂TAAA的内脏重建术式在各个中心仍较局限，存在决策灰区。本共识由国内多位具有丰富TAAA治疗经验的专家在充分总结临床经验和系统回顾分析国内外相关文献的基础上，对TAAA内脏动脉分支重建技术经过多次交流、探讨后总结而成。共识系统闸述了开放手术修复(OSR)、腔内及杂交手术修复TAAA、术后并发症的预防及治疗，就涉及内脏动脉分支重建的复杂TAAA的治疗方式做出推荐，以制定促进TAAA修复的同时重建内脏动脉血运的最佳决策。关健词：主动脉瘤：内脏动脉分支重建：专家共识中图分类号：R543文献标识码：Adoi:10.19418j.cnki.issn2096-0646.2023.04.01Expert consensus on reconstruction of visceral arterial branches in thoracoabdominalaortic aneurysmPeripheral Vascular Disease Committee of Chinese Society of MicrocirculationAbstract:Patients with complex thoracoabdominal aortic aneurysm(TAAA)involving important visceral arterialbranches often have complicated conditions,and extraluminal or endoluminal repair is the main treatment method,withthe continuous update of technology,the indications of the two treatment methods expand continuously.However,theappropriate techniques and materials are still not widely available,the complexity of visceral reconstruction of TAAAis still limited in each center,and there are grey areas for decision making.This consensus is the result of a number ofdiscussions on the technique of visceral arterial branch reconstruction in TAAA by experts with extensive experience in thetreatment of TAAA in China,based on thorough summary of clinical trial experience,systematic review and analysis ofthe relevant domestic and international literature.The consensus systematically discusses the prevention and treatment ofpost-operative complications of open surgery repair (OSR),endovascular and hybrid surgery for TAAA repair,and makesrecommendations on the treatment of complex TAAA involving the reconstruction of visceral arterial branches,in order tofacilitate the formulation of optimal decisions for the reconstruction of visceral arterial blood flow while repairing TAAA.Key words:aortic aneurysm;visceral arterial branch reconstruction;expert consensus1共识形成方法前，临床普遍采用的TAAA分型方法是Crawford分型-刘I型，累及左锁骨下动脉至腹主动脉上段：Ⅱ型，累及范围胸腹主动脉瘤((thoracoabdominal aortic aneurysm,TAAA)最广，从左锁骨下动脉至主动脉分叉部：Ⅲ型，累及远端胸从胸部延伸至腹部的同时常累及重要内脏动脉分支，包主动脉（第6肋以下）并延伸至主动脉分叉；：Ⅳ型，上至膈水括腹腔干、肠系膜上动脉、肾动脉、肠系膜下动脉等。目平的胸主动脉，下至腹主动脉分叉：V型，从远端胸主动脉[基金项目1中央高水平医院临床科研专项(2022-PUMCH-C-062):国家自然科学基金(82070492)[通信作者]郑月宏(Zheng Yuehong,corresponding author),主任医师、，科主任、博士生导师，E-mail:yuehongzheng(@yahoo..com薛冠华(Xue Guanhua,corresponding author),主任医师，E-mail:Guanhuaxue(@eah.net(C)1994-2023 China Academic Journal Electronic Publishing House.All rights reserved.http://www.cnki.net
