Gore C-TAG分段释放联合潜望镜技术处理B型主动脉夹层远端破口  

Gore C-TAG stent-graft segmented release combined with periscope technique for distal reentry tear after thoracic endovascular aortic repair for Stanford B aortic dissection

作　　者：韩晓峰[1] 郭曦[1] 刘光锐[1] 李铁铮[1] Han Xiaofeng;Guo Xi;Liu Guangrui;Li Tiezheng(Department of Diagnostic and Interventional Radiology,Beijing Anzhen Hospital,Capital Medical University,Beijing 100029,China)

机构地区：[1]首都医科大学附属北京安贞医院介入诊疗科,北京100029

出　　处：《中华普通外科杂志》2021年第1期10-14,共5页Chinese Journal of General Surgery

基　　金：国家重点研发计划(2017YFC1308005)。

摘　　要：目的探讨胸主动脉覆膜支架分段释放技术联合“潜望镜”技术在Stanford B型主动脉夹层腔内修复术后远端破口处理中的临床应用价值。方法﹐回顾性分析2019~2020年5例Stanford B型主动脉夹层腔内修复术后胸主动脉远端假腔扩张患者的临床资料。结果5例患者均为男性。主动脉CTA影像资料显示内脏区主动脉存在夹层再破口,支架远端夹层动脉瘤形成。均采用GoreC-TAG支架的分段释放定位联合“潜望镜”技术方法处理夹层远端破口。手术成功率100%,无中转开腹和围手术期死亡病例。术后复查主动脉CTA显示夹层远端破口隔绝完全,分支血管灌注通畅。结论采用Gore C-TAG支架分段释放技术联合“潜望镜”技术方法处理夹层远端破口技术操作简单,成功率高,近期效果满意。Objective To assess the clinical value of Gore C-TAG stent-graft segmented releasemode combined with‘periscope’technique in dealing with distal reentry tear of aortic dissection afterthoracic endovascular aortic repair(TEVAR).Methods The clinical data of 5 patients of distal falselumen enlargement after thoracic endovascular aortic repair for Stanford type B aortic dissection('TBAD)from 2019 to 2020 was retrospectively analyzed.Results All five patients were male.Combining Gore C-TAG stent-graft segmented release mode with‘periscope’technique was used.All five patients successfullyunderwent secondary endovascular repair,no intraoperative thoracotomy or major postoperative complicationsduring hospitalization occurred.Compared to aortic CTA imaging in pre-and post-secondary endovascularrepair,the curative efficacy of this method in the treatment of distal reentry tear of aortic dissection wasevaluated.It showed that distal reentry tears were covered completely without reperfusion of aortic falselumen,as well as branch stents with well-perfusion based on aortic CTA imaging during the first yearfollowing-up.Conclusions Gore C-TAG stent-graft segmented release mode combined with‘periscope'technique in dealing with distal reentry tear of aortic dissection is technically applicable and highly successfulwith satisfactory short-term results.

关 键 词：主动脉疾病 手术后并发症 夹层远端破口 

分 类 号：R654.2[医药卫生—外科学]