腔内修复术治疗非复杂性急性B型主动脉夹层及随访结果  

Thoracic endovascular aortic repair for uncomplicated acute type B aortic dissection and its follow-up outcomes

作　　者：朱建成[1] 朱灏[1] 金国珍[1] 吕存余 徐辉[1] 陈绍良[1] ZHU Jiancheng;ZHU Hao;JIN Guozhen;LÜCunyu;XU Hui;CHEN Shaoliang(Department of Cardiology,Affiliated Nanjing Hospital of Nanjing Medical University,Nanjing,Jiangsu Province 210006,China)

机构地区：[1]南京医科大学附属南京医院(南京市第一医院、南京市心血管病医院)心内科,210006

出　　处：《介入放射学杂志》2020年第4期362-365,共4页Journal of Interventional Radiology

摘　　要：目的评价覆膜支架胸主动脉腔内修复术(TEVAR)治疗非复杂性急性Stanford B型主动脉夹层(ATBAD)的近中期效果,并与复杂性ATBAD作比较。方法回顾性分析2003年5月至2012年6月收治的122例ATBAD患者临床资料。根据临床特征,分为非复杂性ATBAD组(A组,n=73)和复杂性ATBAD组(B组,n=49)。TEVAR术后随访5年,对比两组围手术期并发症、30 d死亡率、5年主动脉相关事件、免于主动脉相关事件发生率和中期生存率。结果 A组与B组相比,围手术期并发症发生率(8.2%对42.9%,P<0.01)、30 d死亡率(0%对12.2%,P=0.008)均显著降低;5年中期随访显示,主动脉相关事件发生率(5.5%对7.0%,P=1.000)、中期死亡率(2.7%对7.0%,P=0.352)均相似,免于主动脉相关事件发生率(P=0.661)、中期生存率(P=0.245)差异均无统计学意义。结论 TEAVR治疗非复杂ATBAD可行、有效。与复杂ATBAD相比,非复杂ATBAD经TEVAR治疗获得了更好的近期效果,中期效果相似。Objective To evaluate the short-to-medium-term effect of thoracic endovascular aortic repair(TEVAR) with covered stent in treating uncomplicated acute type B aortic dissection(ATBAD), and to compare it with complicated ATBAD. Methods The clinical data of 122 patients with ATBAD, who were admitted to hospital from May 2003 to June 2012, were retrospectively analyzed. According to clinical features the patients were divided into group A(uncomplicated ATBAD group, n=73) and group B(complicated ATBAD, n=49). The patients were followed up for 5 years after TEVAR. The perioperative complications, 30-day mortality, 5-year aorta-related events, incidence of exemption from aorta-related events and midterm survival rate were compared between the two groups. Results In group A and group B, the incidences of perioperative complications were 9.6% and 42.9% respectively(P<0.01), the 30-day mortality was 0.0% and 12.2% respectively(P=0.008). Five-year mid-term follow-up results showed that the incidences of aorta-related events were 5.5% and 7.0% respectively(P=1.000), mid-term mortality was 2.7% and 7.0% respectively(P=0.352). There were no statistically significant differences in the incidence of exemption from aorta-related events and the mid-term survival rate existed between group A and group B(P=0.661 and P=0.245, respectively). Conclusion For the treatment of uncomplicated ATBAD, TEVAR is feasible and effective. Compared with complicated ATBAD, TEVAR can achieve better short-term results and similar midterm results in uncomplicated ATBAD.

关 键 词：急性 非复杂性 STANFORDB型主动脉夹层 胸主动脉腔内修复术 

分 类 号：R543.1[医药卫生—心血管疾病]