摘要
目的 探讨血管腔内治疗主动脉夹层和夹层动脉瘤的技术方法和疗效。 方法 对2 0例主动脉夹层和夹层动脉瘤患者的临床资料进行分析。StanfordA型 2例 ,其中 1例内膜撕裂口位于升主动脉。StanfordB型 1 8例。 5例在不同部位有 2个以上撕裂口。全组均以带膜支架型人工血管腔内植入行隔绝术。其中 1例加作腹主动脉开窗和人工血管置换术 ,1例先行升主动脉 左锁骨下动脉和左颈总动脉Y形人工血管旁路术 ,再行腔内隔绝术。 结果 无一例患者术中死亡 ,术后 3d1例StanfordB型患者死于心肌梗死 ,其余 1 9例健康存活 ,生存率 95 %。术后随访 1～ 2 0个月 ,各例主动脉夹层和动脉瘤均消失 ,无内漏 ,各器官灌注良好。 结论 血管腔内植入带膜支架型人工血管是治疗主动脉夹层和夹层动脉瘤的简便、安全而有效的方法。手术死亡率低 。
Objective To study the techniques and therapeutic effects of endovascular stent graft exclusion in aortic dissection and dissecting aneurysm. Methods The clinical data of 20 cases with aortic dissection and (or) dissecting aneurysm were analysed. Stanford A dissection was found in 2 cases, in which one had a tear entry on ascending aorta. Stanford B dissection was found in 18 cases. Five patients had two or more tear entries in different sites. Endovascular polyester covered stent graft exclusion was performed in all cases, of which, one case was also given fenestration and graft replacement and one subjected to Y graft bypass from ascending aorta to the left common carotid artery and left subclavian artery before endovascular stent graft exclusion. Results No one died in operation. One patient died of heart infarction on the third day after operation. During the followup of 1～20 months, 19 patients were alive well(95%). The aortic dissections and(or) dissecting aneurysms of all the patients disappeared without endoleaks and organ or limb ischemia. Conclusion Endovascular stent graft exclusion with high successful rate, low mortality and high survival rate, is simple, safe and effective in treating aortic dissection and dissecting aneurysm.
出处
《中华外科杂志》
CAS
CSCD
北大核心
2003年第7期487-490,共4页
Chinese Journal of Surgery
