腔内隔绝术治疗胸主动脉夹层(附25例临床分析)  

Endovascular graft exclusion in treating thoracic aortic dissection: a report of 25 cases

作　　者：陈伟[1] 杨建勇[1] 庄文权[1] 郭文波[1] 李鹤平[1] 钟丽珍[1] 黄秋萍[1] 

机构地区：[1]中山大学附属第一医院放射科,广州510080

出　　处：《中华放射学杂志》2003年第11期1007-1010,1011,共5页Chinese Journal of Radiology

摘　　要：目的　探讨腔内隔绝术治疗胸主动脉夹层的方法和疗效。方法　对 2 5例 (年龄 4 2～ 72岁 ;男 2 3例 ,女 2例 )胸主动脉夹层患者行腔内隔绝术 ,并进行临床分析和随访 ,评价其临床改善程度与真假腔的变化。结果　在全麻下 2 5例均成功进行了胸主动脉夹层的血管腔内隔绝术 ,其中 1例为StandfordA型 ,共使用Talent带膜血管支架 2 8个 ,术中造影证实夹层裂口完全封闭或内漏显著减少 ,无术中严重并发症及死亡发生 ,2 5例随访 2～ 2 0个月 ,临床效果良好 ,假腔内血栓形成。结论　应用带膜血管内支架行腔内隔绝术是治疗胸主动脉夹层安全有效的方法 。Objective To evaluate the usefulness and efficacy of endovascular graft exclusion (EVGE) in treating thoracic aortic dissection (TAD). Methods Twenty-five cases of TAD, including 24 cases of Standford B and 1 case of A, were treated by EVGE. The clinical outcome and morphological changes of the lesions were analyzed during a 2-20 months′ follow-up. Results Procedures were technically successful in all 25 cases, while a total of 28 stent-grafts were deployed (3 cases with 2 stent-grafts in each). Complete disappearance of the false lumen or remarkable decrease of the endoleak was noted on the angiograms after stent placement. No severe procedure-related complication was observed, and thrombosis of the false lumen was noted during the follow-up. Conclusion EVGE is effective and reliable in treating TAD, especially for patients with sub-acute or chronic courses.

关 键 词：胸主动脉夹层 治疗 腔内隔绝术 随访 慢性期 血管腔 亚急性期 全封闭 内漏 

分 类 号：R543.1[医药卫生—心血管疾病]