主动脉夹层动脉瘤的血管内支架治疗  

Endovascular Stent in the Treatment for Aortic Dissecting Aneurysm

作　　者：杨瑞民[1] 赵保生[1] 李奋保[1] 张丽娟[1] 张希中[1] 孙建明[1] 杨凯[1] 

机构地区：[1]新乡医学院第一附属医院介入科,河南卫辉453100

出　　处：《实用放射学杂志》2007年第9期1224-1226,共3页Journal of Practical Radiology

摘　　要：目的评价血管内支架置入治疗主动脉夹层动脉瘤的安全性和临床疗效。方法48例Stanford B型主动脉夹层动脉瘤患者行腔内修复术。所有患者在DSA下行左肱动脉穿刺插管、造影,了解主动脉真、假腔,夹层裂口及其与重要血管分支位置关系。腹股沟区纵切口显露股动脉,送入人工血管输送器至病变处,准确定位后,释放人工血管进行腔内修复。术后复查造影,观察真、假腔血液动力学变化,内脏及下肢动脉供血的改变。结果48例患者一次性成功置入人工血管支架,2例支架未能完全封堵漏口,内漏明显,手术成功率95.8%。支架置入后假腔血压下降,机体脏器缺血状况改善,临床症状好转或消失。结论支架性人工血管腔内修复术治疗主动脉夹层动脉瘤安全可行、效果明显,值得临床进一步推广。Objective To evaluate the safety and clinical efficacy of a stent - graft in the treatment for type B aortic dissecting aneurysm. Methods 48 patients with Stanford B aortic dissecting aneurysm were treated with endovacular stent - graft under fluoroscopy guidance. Prior to the procedure, aortic angiography was performed in all patients via the left brachial artery to determine the true and false lumen of the aorta, the orifice of the aortic dissection and the other branches of the aortic artery. After surgical exposure of the right femoral artery, the stent - graft delivery system was passed over the stiff guidewire and advanced until the middle of the stent - graft cover the orifice. The stent - graft was then deployed by pulling back the introducer sheath. Then an aortic angiography was performed immediately after the procedure to evaluate the correct placement of the stent -graft and the changes of blood flow supply the true lumen of the aorta, the viscus and the lower limbs. Results Stent - graft placement was technically successful in all patients, and the orifice of the aortic discussion was occluded in 46 patients with a successful rate of 95.8%. The blood pressure of false lumen was dropped immediately after the procedures with improvement of the blood flow in the lower limbs and the viscus greatly. Conclusion Transluminal endovascular stent - graft placement is a safe and effective procedure in the treatment for type B dissecting aneurysm and worthy of spreading extensively.

关 键 词：主动脉夹层 腔内修复术 动脉瘤 介入放射学 

分 类 号：R732.21[医药卫生—肿瘤] R815[医药卫生—临床医学]