探讨基底节区脑出血合并Stanford B型主动脉夹层动脉瘤、肾移植术后患者合并Stanford B型主动脉夹层动脉瘤以及复杂型腹主动脉瘤进行腔内隔绝术的可行性。

对4例特殊类型的动脉瘤行腔内隔绝治疗，1例为基底节区脑出血合并Stanford B型主动脉夹层动脉瘤，1例为肾移植术后合并Stanford B型主动脉夹层动脉瘤，2例为瘤颈成角大于70°，瘤颈长1.6 cm，髂动脉严重扭曲。

2例主动脉夹层动脉瘤患者术后未发生内漏，术中应用小剂量肝素，减少造影剂，建立稳定的低血压，有效地保证了脑和移植肾血流灌注，防止了脑部再出血和移植肾的功能损害；2例腹主动脉瘤患者，通过拉紧两端导丝克服血管扭曲的方法使带膜支架顺利释放，带膜支架成角严重时在成角处加放裸支架。其中1例瘤颈发生内漏，支架0.4 cm移位，降压治疗1周后复查螺旋CT血管成像（CTA）内漏基本消失，1例髂外动脉带膜支架成角未及时加放裸支架，术后因成角处血流缓慢出现血栓形成，急诊行股—股搭桥。4例患者均痊愈出院。

应用腔内隔绝治疗脑出血和肾移植后合并主动脉夹层动脉瘤、复杂型腹主动脉瘤是可行的。

To investigate the clinical feasibility of basal ganglion intracerebral hemorrhage, postopratiive rehabilitation of renal transplantation combined with Standford B type aortic dissection aneurysm(ADA), and complicated type abdominal aortic aneurysm (AAA) with the treatment of endovascular stent-graft exclusion(EVGE).

4 cases of aneurysms were reported: one case was a patient with basal ganglion intracerebral hemorrhage combined with Standford B type aortic dissection aneurysm, one was the postopratiive rehabilitation of renal transplantation combined with Standford B type aortic dissection aneurysm, and the other two cases were the complicated type AAA, which characterized as an over-70°degree corner formed by tumor neck, the length of tumor neck being 1.6 cm, and severe tortuous iliac artery. The EVGE was used to treat these type diseases.

Internal hemorrhage was not found in the two cases of ADA, since low-dose heparin, reduced contrast medium, and maintained stable low blood pressure were construced in the operation, which ensured the blood perfusion and prevented their functional lesion from brain and kidney. As far as two AAA were concerned, the vascular stent was smoothly released by guide wire-tighted tortuous artery, nude stent was added to place at the formed corner to avoid thrombsis. Unfortunately, one of them produced internal leak and stent displace. The treatment for the condition was to lower blood pressure and reduced leak. The other produced the thrombus at the formed corner, whose treatment was urgent operation bypass grafting. Finally, the 4 cases of patients were discharged healthily.

Basal ganglion intracerebral hemorrhage, postopratiive rehabilitation of renal transplantation combined with Standford B type ADA, and complicated type AAA with the treatment of EVGE is feasible.