摘要
目的探讨裸支架联合弹簧圈治疗远端破口位于腹腔干的主动脉夹层的新方法。方法上海交通大学附属第六人民医院血管外科2007年4月至2010年8月，2例StanfordB型主动脉夹层近端破口以覆膜支架封闭后，确认远端破口位于腹腔干且难以自愈，采用裸支架植入腹腔干，跨过破口，并以导管经支架网孔穿过破口进入假腔，将适当数量的弹簧圈植人假腔，在阻断进入假腔的血流的同时保持腹腔干动脉通畅。结果手术均成功，术后造影假腔不显影，腹腔干通畅。无并发症发生。分别随访5年和2年，假腔消失，腹腔干通畅。结论裸支架联合弹簧圈，技术简单，仅需穿刺即可完成，避免了开放手术、杂交手术的巨大创伤，理论上可以用于破口位于腹腔各个大分支动脉的情形，作为腔内修复术的补充技术，使部分复杂StanfordB型夹层达到“根治”效果。
Objective To evaluate a novel method of combining use of bare stent and coils in the treatment of aortic dissection with distal tear at celiac trunk. Methods From April 2007 to August 2010, two cases of Stanford type B dissections underwent initially endovascular stent-grafting to seal proximal tears while distal tears at celiac trunks failed to seal spontaneously. Bare stents were then implanted into celiac trunks crossing tears. And an appropriate amount of coils were pushed into false lumen via a catheter passing through the holes of stents for maintaining the patency of celiac trunk and sealing tears. Results Both procedures succeeded. False lumen was indistinct on angiography while celiac trunks were patent. No complication occurred. After the follow-up periods of 5 and 2 years respectively, false lumen disappeared and celiac arteries became patent. Conclusion The novel method of combining use of bare stent and coils is technically simple. It required a simple puncture. Major traumas of open and hybrid operations are avoided. It is also indicated for cases of tears at renal or superior mesenteric arteries. As a supplemental method for conventional TEVAR, radical cure may be achieved for some complicated Stanford B dissections.
出处
《中华医学杂志》
CAS
CSCD
北大核心
2012年第47期3333-3335,共3页
National Medical Journal of China
