摘要
目的总结主动脉夹层的治疗经验。方法26例主动脉夹层患者腔内修复按常规方法进行，其中左锁骨下动脉受累1例，采用颈部切口头臂动脉旁路移植后经股动脉切1：3逆行主动脉腔内覆膜支架置入，覆盖左锁骨下动脉。术后观察患者并发症发生情况及术后3个月、术后1年CT复查，观察支架和人工血管通畅情况及假腔变化。结果围术期无死亡和严重并发症发生。所有患者支架均成功释放到预定位置。23例支架无明显内漏和移位。2例患者术中造影存在多发破口；1例与主动脉成角大于30度，分别再次支架置入。随访26例，随访时间3．0～38．0个月。1例术后3个月心源性猝死，其余患者均生存，恢复正常生活。术后3个月和术后1年复查主动脉增强CT示支架无移位和内漏，移植的人工血管通畅。结论主动脉夹层腔内治疗结果肯定，早期随访效果满意。
Objective To summarise the treatment experience of endovascular repair （EVR）for type B acute aortic dissection（AAD）. Methods A total of 26 consecutive patients with acute aortic dis- section were enrolled. All patients were treated by EVR. Among them, 1 patient was involved in left subcla- vian artery. Brachiocephalic artery bypass via neck incision with retrograde endovascular stem graft implan- tation was used, covering left subclavian artery. Incidence of postoperative complications was closely moni- tored after operation. Computed tomography （CT） , general condition of stent-graft, and blood flow of bypass graft were followed up at three months and one year respectively after operation. Results No death or se- vere complications occurred peri-operatively. The procedures were technically successful with stent-grafts implanted. No obvious translocation or endoleakage of the stent-grafts occurred in 23 patients. Muhiple rup- tures or angulations were defined in 3 patients and stent grafts were re-implanted. All patients were fol- lowed up for 3.0 - 38.0 months. One patient died of sudden cardiogenic death, and the others recovered to normal social life. Enhanced CT scanning at three months and one year after operation confirmed no en- doleakage or translocation of stent grafts and the patency of bypass grafts. Conclusion The endovascular repair of acute type B dissection is effective and the short-term outcome is satisfactory.
出处
《临床外科杂志》
2012年第10期711-712,共2页
Journal of Clinical Surgery
关键词
主动脉夹层
支架
腔内治疗
aortic dissection
stent-graft
endovascular repair
