带膜支架腔内隔绝术治疗B型主动脉夹层40例分析  

Endovascular Stent-graft For Treating Type B Aortic Dissection in Forty Cases

作　　者：张仁宇[1] 杨建[1] 杨帆[1] 谭今[1] 

机构地区：[1]四川大学华西医院胸心外科,四川成都610041

出　　处：《华西医学》2009年第1期50-52,共3页West China Medical Journal

摘　　要：目的：探讨带膜支架腔内隔绝术治疗B型主动脉夹层的技术方法及疗效。方法：对近年我院收治的40例主动脉夹层进行分析。40例患者均行股动脉穿刺插管至升主动脉造影，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。切开右或左侧股动脉置人覆膜血管内支架，封堵原发破口，置入支架后重复造影检查。观察真假腔血流变化、主动脉分支供血的情况。结果：40例患者支架置入定位准确，术后即刻造影显示真腔血流恢复正常。手术成功率100％，无术中转开胸手术，无截瘫及瘤体破裂等严重并发症，无围手术期死亡。所有患者术后3～6个月复查增强CT，假腔不再显影，支架通畅，无扭曲、移位。结论：带膜支架腔内隔绝术治疗B型主动脉夹层具有创伤小，术后恢复快，手术死亡率低，手术成功率高的优点，但远期效果有待进一步观察。Objective：To investigate the echnique and efficacy of endovascular stent-grafts in treating type B aortic dissection. Methods：Forty patients with type B dissection were analyzed. The forty patients had been performed visualizations of aorta which should be well identified through femoral artery,so that we can comprehend true lumen,false lumen and the position of tear relation to the important branches. Vascular access was obtained through femoral artery after surgical arteriotomy and stent graft was inserted in the true lumen to occlude the primary entry o the tear,immediate aortography was performed after this procedure, then the change of blood current in the true and false lumen was observed. Results：Stent-graft deployment was successfully performed,we can see the blood current in the true lumen have been normal through aortography. The achievement ratio of operation was 100 %. There were no severe procedure-related complications and accidents related to the dissection and surgery including paraplegia and angiorrhexis, there was no death in the ambi-operation time. Three to six months later, all patients were checked by CT, there was false lumens in the picture, the stent-graft was patent and smooth, no distortion or movement was found. Conclusion：Endovascular stentgrafts deployment has many fortes in treating type B aortic dissection,but further observation will be needed for evaluation of long-term results.

关 键 词：主动脉夹层 带膜支架 介入治疗 

分 类 号：R543.1[医药卫生—心血管疾病]