锚定区不足的胸主动脉覆膜支架植入术应用及疗效观察  

Application and Clinical Effect Observation of Thoracic Aortic Covered Stent Implantation with Insufficient Proximal Landing Zone

作　　者：贺宝臣 刘煜[1] 叶海峰[1] 陈德峰[1] 赵和有[1] 张健[1] 

机构地区：[1]河北省邯郸市中心医院心血管外科,邯郸056000

出　　处：《中国医药导刊》2016年第5期433-434,共2页Chinese Journal of Medicinal Guide

基　　金：河北省卫生厅计划项目(编号:20130361);课题名称:胸主动脉覆膜支架左锁骨下动脉覆盖严重脑缺血初步研究

摘　　要：目的探讨锚定区不足的胸主动脉覆盖支架植入术应用及临床疗效.方法：选择2005年1月～2015年10月期间,我院收治的86例锚定区不足胸主动脉病变患者为研究对象,所有患者均行覆膜支架置入术,其中A组为完全覆盖左锁骨下动脉开口（6 0例）,B组为部分覆盖左锁骨下动脉开口（2 6例）,对两组双上肢收缩期压差、L S A显影以及术后内漏情况进行对比.结果：所有患者均顺利置入支架,A组左右两侧的双上肢收缩期血压差比较差异有统计学意义（P〈0.05）;而B组的左右两侧双上肢收缩期血压差比较差异无统计学意义（P〉0 . 0 5）;同时,两组在L S A显影和内漏发生率方面比较差异有统计学意义（P〈0.05）.结论：临床上在运用锚定区不足的胸主动脉覆盖支架植入术时,依适应证对双侧颈动脉和椎动脉血供情况进行评估和对应的治疗方案.Objective: To explore the application and clinical therapeutic effect of thoracic aortic covered stent implantation with insufficient proximal landing zone.Methods:From January 2005~October 2015,86 cases of our hospital during the period of anchoring area less than patients with thoracic aortic lesions as the research object,all the patients were coated carotid stenting,which is completely covered in group A left subclavian artery opening,group B for part of the cover opening left subclavian artery,the two sets of double arms systolic pressure difference,LSA enhancement and postoperative leakage conditions were compared.Results:All patients were successfully placing stents,A set of left and right sides of the double arm systolic blood pressure differential comparative difference was statistically significant (P<0.05); And group B left and right sides of the double arm systolic blood pressure differential comparative differences had no statistical significance (P>0.05); At the same time,the two groups in the LSA enhancement and incidence of leakage of comparative difference was statistically significant (P<0.05). Conclusion:In clinical use of anchoring area was less than the thoracic aorta covered stent implantation,the treatment scheme according to the indication of bilateral carotid artery and vertebral artery blood supply were evaluated and corresponding.

关 键 词：动脉瘤 主动脉 锚定区 支架植入术 

分 类 号：R543[医药卫生—心血管疾病]