体外预开窗腔内修复治疗非健康锚定区及短锚定区B型主动脉夹层的前瞻性单中心研究  

The treatment of Stanford type B aortic dissection with unhealthy or short anchoring zone using physician-modified fenestration TEVAR

作　　者：胡凡果[1] 朱杰昌[1] 戴向晨[1] 罗宇东[1] 范海伦[1] 冯舟[1] 张益伟[1] Hu Fanguo;Zhu Jiechang;Dai Xiangchen;Luo Yudong;Fan Hailun;Feng Zhou;Zhang Yiwei(Department of Vascular Surgery,Tianjin Medical University General Hospital,Tianjin 300052,China)

机构地区：[1]天津医科大学总医院血管外科,300052

出　　处：《中华普通外科杂志》2020年第7期536-539,共4页Chinese Journal of General Surgery

摘　　要：目的评价体外预开窗胸主动脉腔内修复术(TEVAR)治疗非健康锚定区及短锚定区B型主动脉夹层的有效性与安全性.方法前瞻性分析2016年5月至2018年12月44例行左锁骨下动脉(LSA)开窗TEVAR的B型主动脉夹层患者的临床资料.结果技术成功率93.2%,1例患者LSA窗对位不准,改为烟囱支架.1例术后造影伴Ⅰ型内漏.1例术中LSA窗孔有Ⅲ型内漏.围手术期无死亡病例,无神经系统并发症,平均住院时间9.2(5~26)d.中位随访时间30(12~42)个月,随访期间发现Ⅰ型内漏1例,无逆撕夹层,所有LSA分支均保持通畅.结论体外预开窗TEVAR治疗非健康锚定区及短锚定区B型主动脉夹层是安全可行的.Objective To evaluate the efficacy and safety of physician-modified fenestration TEVAR for treating type B aortic dissection with unhealthy or short anchoring zone.Methods Clinical data of patients with type B aortic dissection who received TEVAR for left subclavian artery fenesration from May 2016 to Dec 2018 were analyzed prospectively.Results The technical success rate was 93.2%.One case was converted into chimney stenting.One case suffered type Ⅰ endoleak.One case had type Ⅲ endoleak.There were no deaths or neurological complications during the perioperative period,and the mean hospital stay was 9.2(5-26)days.The median follow-up time was 30(12-42)months.One case developed type Ⅰ endoleak during follow-up.No retrograde dissection occurred and all LSA stents remained patent.Conclusion Physician-modified fenestration TEVAR is safe and effective for the treatment of type B aortic dissection with unhealthy or short anchoring zone.

关 键 词：主动脉疾病 支架 开窗技术 

分 类 号：R654.2[医药卫生—外科学]