摘要
目的评价用主动脉夹层动脉瘤腔内隔绝术治疗StanfordB型主动脉夹层动脉瘤的近、中期临床疗效。方法2002年5月至2006年9月,行主动脉腔内隔绝术治疗B型主动脉夹层46例。其中男36例,女10例;年龄62±18岁。46例均经股动脉切开置入覆膜支架封堵胸主动脉破裂口,置入后造影检查证实疗效,术后随访1~52个月,平均17±16个月,分析其临床特点及疗效。结果住院期间及随访30d内无患者死亡;发生主动脉腔内隔绝术后综合征11例;2例患者左锁骨下动脉被封闭;5例发生内漏,术后3个月时其中4例内漏自行封闭。随访3个月时,所有患者内膜破裂口封闭,胸降主动脉和腹主动脉真腔扩大,假腔内血栓形成,支架位置、形态正常。术后半年1例发生截瘫,原因不明。术后1年1例出现迟发性内漏;1例升主动脉发现夹层,未行外科手术。随访期间3例死亡,4年生存率89.3%。结论用主动脉夹层动脉瘤腔内隔绝术治疗B型主动脉夹层动脉瘤的近、中期疗效满意。
Objective To evaluate in-hospital and mid-term results of endovascular type B aortic dissection by stent graft. Methods From May 2002 to September 2006, 46 patients with type B aortic dissection underwent stentt graft implantation. The study included 36 men and 10 women with mean age of 62 ± 18 years old. Twenty one patients underwent stent-graft implantation in the acute phase and the other 25 patients in the chronic phase. All patients were followed up for 1 to 52 months （average 17 ± 16 months） and the clinical data of the patients were analyzed. Results No patients died during hospitalization and within 30 days after operation. Transient post-implantation syndrome occurred in 11 patients. Left subclavian artery was totally occluded in 2 patients. Endoleak occurred in 5 patients and in 4 of them the leak closed spontaneously after three months of follow-up. Late endoleak occurred in 1 patient after one year. One patient developed paraplegia at 6 months after the operation. The follow-up CT scan at 3 months documented occlusion of the intimal tear by the stent-grafts and complete thrombosis of the false lumen in all patients. The true lumen of the aorta was enlarged and there was no evidence of migration or twisting of the stent-grafts. Ascending aortic dissection occurred in 1 patient after one year. Three patients died within the follow- up period. The mortality during the follow-up period was 6.7%. The actuarial survival curve by the Kaplan-Meier method showed a 4-year survival rate was 89.3%. Conclusion In-hospital and mid-term results showed that endovascular repair was effective in the treatment of type B aortic dissection.
出处
《中国介入心脏病学杂志》
2007年第2期80-83,共4页
Chinese Journal of Interventional Cardiology
关键词
主动脉瘤
胸
动脉瘤
夹层
支架
Aortic aneurysm, thoracic
Aneurysm, dissecting
Stents
