腔内隔绝术治疗Stanford B型主动脉夹层的疗效  

Endovascular graft exclusion in treatment of aortic dissection(Stanford B):a report of 107 cases

作　　者：郭飞杰[1,2] 李晓东[1,2] 郭德和[1,2] 刘旭东[1,2] 

机构地区：[1]宁夏医科大学,宁夏银川750004 [2]宁夏医科大学附属医院,宁夏银川750004

出　　处：《宁夏医学杂志》2010年第2期128-130,共3页Ningxia Medical Journal

摘　　要：目的探讨应用覆膜支架腔内隔绝术治疗Stanford B型主动脉夹层的方法和效果。方法对102例(男84例,女18例,年龄28-83岁)主动脉夹层腔内隔绝术患者的临床资料进行回顾性分析。术前采用CT血管成像(CTA)、经胸心脏超声(TTE)、磁共振血管成像(MRA)等技术对主动脉夹层进行评估。术中穿刺左肱动脉行主动脉造影了解破口的位置及撕裂的范围,术中在数字减影血管造影(DSA)监视下经股动脉将覆膜支架送入胸主动脉封闭夹层破口。结果102例成功进行了主动脉夹层腔内隔绝术。术后主动脉造影证实夹层裂口完全封闭或内漏明显减少,无中转开胸手术。术后随访1-48个月(平均24个月),99例行CTA复查,有3例病人在术后1个月死亡。结论覆膜支架腔内隔绝术是治疗主动脉夹层动脉瘤的安全、有效的方法,近期疗效好。手术死亡率和并发症发生率低,手术成功率和生存率高。Objective To introduce the techniques and effects of endovascular stent-graft exclusion in the treatment of aortic dissection （Stanford B）. Methods Endovascular graft exclusion was performed in 107 patients with aortic dissection. Computed tomography angiography （CTA）, transthoracic echocardiography （TIE）, magnetic resonance angiography （MRA） was used as a preoperative evaluation methods. The position and extent of the aortic dissection were analyzed through angiography. The stent - grafts were inserted from the femoral artery to exclude the aneurysm, and all operations were performed under DSA guidance. Results Endovascular graft exclusion was successfully performed in all 107 patients. After operation, angiography of aorta showed the dissection aneurysm was excluded absolutely, or the inner leak reduced obviously. No patient had to appeal to thoracic surgery. The range of postoperative follow -up was form 1 to 48 months （average 24 months）. 104 of the patients accepted a reexamination of CTA. 3 patients was death in 1 month after operation. Conclusion Endovascular graft exclusion is a secure and effective way to treat aortic dissection, the death rate and complications is lower by this operation, and rate of success and survival could be acquired after the operation.

关 键 词：动脉瘤 主动脉夹层 腔内隔绝术 支架 

分 类 号：R543.1[医药卫生—心血管疾病]