降主动脉扩张病变腔内修复的初步探讨  

Endovascular Repair of Descending Aorta Dilatation

作　　者：车辙[1] 吴继东[2] 杨孙虎[1] 高鹏程[1] 吴晓阳[1] 柴瑾[1] 

机构地区：[1]甘肃省张掖市人民医院普外科,张掖734000 [2]中国医学科学院中国协和医科大学北京协和医院血管外科,北京100032

出　　处：《中国微创外科杂志》2012年第5期393-395,共3页Chinese Journal of Minimally Invasive Surgery

摘　　要：目的探讨降主动脉扩张性疾病腔内修复术的有效性和安全性。方法 2009年5月～2011年12月,对20例降主动脉扩张性疾病行腔内修复手术。术前全部应用CTA确诊,其中Stanford B型夹层15例,假性动脉瘤4例,降主动脉减速伤1例。均在全麻下行股动脉切开作为覆膜支架置放入路。结果全组均一次支架释放成功,无手术死亡。修复后造影显示降主动脉夹层破口或假性动脉瘤均被即刻封闭,真腔均较术前扩大。2例主动脉腹腔分支段破口遗留假腔,假腔直径均<10 mm,未给予处理。14例术后6个月行CTA检查,无支架移位、破裂、断裂、内漏发生,第一破口所致假腔均无活动血流。结论腔内修复治疗降主动脉扩张性疾病安全,有效。Objective To discuss the efficacy and safety of endovascular repair for descending aortic dilatation. Methods From May 2009 to December 2011, 20 patients with descending aortic dilatation received endovascular repair in our hospital. With preoperative CTA, the patients were diagnosed with Starford B type descending aortic dissection （15 cases）, pseudoaneurysm （4 cases） , or descending aortic trauma （ 1 case）. The operation was performed under general anesthesia, and femoral artery was used for stent placement. Results The procedure was completed in one session in all the patients. None of them died. Postoperative angiography showed that the ruptured or false aneurysm of the descending aorta dissection was immediately closed. Two patients showed a false cavity （ 〈 10 mm in diameter） at the rupture site of the abdominal aorta after the surgery, but received no treatment. Reexamination in 6 months by CTA was carried out in 14 patients, none of them had stcnt displacement or break, or internal leakage; no active bleeding was observed at the false cavities caused by the original rupture. Conclusion Endovascular repair is effective and safe for descending aorta dilatation.

关 键 词：主动脉夹层 STANFORD B 腔内修复 

分 类 号：R654.3[医药卫生—外科学]