血管内带膜支架置入术在主动脉夹层治疗中的初步应用  

Preliminary experience of endovascular stent-graft placement for patients with aortic dissection

作　　者：王祥[1] 曾秋棠[1] 李大主[1] 毛奕[1] 吴桂芳[1] 尹爱珍[1] 冯义柏[1] 曹林生[1] 

机构地区：[1]华中科技大学协和医院心内科华中科技大学同济医学院心血管病研究所,武汉430022

出　　处：《临床心血管病杂志》2004年第11期643-645,共3页Journal of Clinical Cardiology

摘　　要：目的 :探讨血管内带膜支架置入术治疗主动脉夹层的疗效。方法 :采用MedtronicTalentTM带膜支架置入治疗 5例StanfordB型亚急性期主动脉夹层患者 ,在全麻、数字减影血管造影术 (DSA)监控下 ,切开股动脉 ,将带膜支架系统置入降主动脉内膜破裂口处 ,封闭破口。结果 :所有患者带膜支架置入后破口完全封闭 ,真腔血流恢复正常 ,技术成功率 10 0 %。无急诊开胸手术、截瘫、瘤体破裂等严重并发症 ,无围手术期死亡。 1例术中发生新的StanfordA型夹层 ,所有患者在 1～ 8[平均 (4 .5 5± 2 .1) ]个月的随访期内经螺旋CT证实无内漏及支架移位等并发症发生。结论 :血管内带膜支架置入术治疗亚急性降主动脉夹层具有技术可靠、安全性高、术后恢复快、手术成功率高等优点 。Objective:To introduce the preliminary experience of endovascular stent-graft (ESG) placement for patients with type B aortic dissection. Method: Five patients (male 4,female 1) aged 34～50 years with subacute aortic dissection were treated with ESG under digital subtraction arteriography(DSA).Entry tears were located in the descending thoracic aorta in all patients. Result:Stent-grafts were placed successfully in all patients. All ruptures were completely closed and the blood flow returned to normal in the true lumen. There was a new dissection in ascending aorta in one patient. However, there was no death or other serious complications at perioperation and during the subsequent average follow-up period of 4.5 months. No secondary stent-graft procedures were required in all patients. Conclusion: ESG placement of subacute aortic dissection is a safe, reliable and effective method and may be an alternative to surgical graft replacement in selective patients.

关 键 词：血管内带膜支架 主动脉夹层 

分 类 号：R543.6[医药卫生—心血管疾病]