覆膜支架主动脉腔内修复治疗主动脉夹层78例  

Endovascular repair of aortic dissection (Report of 78 cases)

作　　者：许尚栋[1] 黄方炯[1] 李志忠[2] 王学勇[3] 杨禁非[1] 蔡克强[1] 范占明[4] 杜嘉会[4] 张兆光[1] 

机构地区：[1]北京心肺血管疾病研究所首都医科大学附属北京安贞医院心脏外科,100029 [2]北京心肺血管疾病研究所首都医科大学附属北京安贞医院抢救中心,100029 [3]北京心肺血管疾病研究所首都医科大学附属北京安贞医院麻醉科,100029 [4]北京心肺血管疾病研究所首都医科大学附属北京安贞医院放射科,100029

出　　处：《中华胸心血管外科杂志》2006年第3期149-151,共3页Chinese Journal of Thoracic and Cardiovascular Surgery

摘　　要：目的探讨主动脉夹层腔内修复术的疗效。方法2001年6月至2005年5月,行覆膜支架腔内修复治疗主动脉夹层78例。男71例,女7例;年龄31～80岁,平均(52.7±12.3)岁。StanfordB型76例,StanfordA型2例。术后随访1～47个月,平均(13.0±10.1)个月。建立数据库,分析其临床特点及疗效。结果近端内漏5例;升主动脉夹层5例,其中1例术中发生,4例分别在术后1、7d、5、13个月发生。术后30d内死亡4例(5.1%),2例死于升主动脉夹层破裂,1例死于急性肾功能衰竭,1例死于脑出血。术中脑梗塞1例。5例病人因覆膜支架远端再发现破口,行二次腔内修复术。1例因内漏行二次腔内修复术。随访期死亡3例(3.8%),分别死于消化道出血、升主动脉夹层破裂和死因不明。结论覆膜支架腔内修复术是治疗主动脉夹层的有效方法,但远期效果还有待进一步观察。Objective To evaluate the feasibility and safety of endovascular repair of aortic dissection. Methods June 2001 to May 2005,78 patients with aortic dissection received endovascular repair. There were 71 males and 7 females with average age of （52.7±12.3） years （31-80 years）. The classification included 76 Stanford B dissection and 2 Stanford A dissection. Patients were followed from 1 to 47 months, average （13.0±10.1 ） months. The clinical data of the patients was analyzed, Results There were 5 type i endoleaks. Ascending aortic dissection occurred during operation in 1 case. Four ascending aortic dissections occurred at 1 day, 7 days, 5 months and 13 months after stent-graft implantation respectively. Four patients died within 30 days after operation. The causes of death were rupture of the ascending aortic dissection in 2 cases, acute renal failure in 1, and stroke in 1. 30-day mortalit）, was 5.1%. Five patients received second stent-graft implantation because of reentry distal to the stent-graft. One patients received second stent-graft implantatien because of type 1 endoleak. Three patients died during follow-up time. Mortality during follow up period was 3.8%.Conclusion Early results of endovascular repair of aortic dissection were satisfactory. Long time results were still under observation.

关 键 词：动脉瘤 夹层 主动脉 胸 心脏外科手术 

分 类 号：R654.3[医药卫生—外科学]