B型主动脉夹层的主动脉腔内修复联合远端限制性支架术中及远期临床效果评价  

prevention of distal stent graft-induced new entry after endovascular repair for type B aortic dissection:thoracic endovascular aortic repair plus restrictive stent

作　　者：李昊锟 姜维良[1] 李宪伟[1] 陈哲 LI Haokun;JIANG Weiliang;CHEN Zhe;LI XianwEI(Department of Vascular Surgery,the Second Affiliated Hospital of Harbin Medical University,Harbin 150000,China)

机构地区：[1]哈尔滨医科大学附属第二医院血管外科,150000

出　　处：《心肺血管病杂志》2021年第4期354-359,367,共7页Journal of Cardiovascular and Pulmonary Diseases

摘　　要：目的:研究主动脉腔内修复术(TEVAR)联合远端限制性支架(RS)治疗B型主动脉夹层的中、远期临床效果。方法:对2010年6月至2018年12月,哈尔滨医科大学附属第二医院血管外科接受TEVAR或TEVAR+RS治疗的B型主动脉夹层患者资料进行回顾性分析。结果:共239例患者纳入研究,男性185例,女性54例,年龄24-80岁,平均年龄(54.2±10.7)岁。TEVAR组111例,TEVAR+RBS组128例。手术成功率100%。TEVAR+RS组较TEVAR组支架远端新发破口(dSINE)发生率明显降低[14/111(12.6%)"s.2/128(1.6%),P=0.0007],同时主动脉假腔重构也明显优于TEVAR组。结论:应用胸主动脉腔内修复术联合RS治疗B型主动脉夹层,不仅能够有效地减少dSINE发生,并且有利于主动脉夹层假腔重构,具有良好的中-长期疗效。Objective:To study the thoracic endovascular aortic repair(TEVAR)with a distal restrictive stent(RS)in the treatment of B type aortic dissection in Medium and long-term clinical effects.Methods:The data of patients with type B aortic dissection who received TEVAR or TEVAR+RS treatment in the Vascular Surgery Department of the Second Affiliated Hospital of Harbin Medical University from June 2010 to December 2018 were retrospectively analyzed.Results:A total of 239 patients were included in the study,including 185 males(185/239,77.4%)and 54 females(54/239,22.6%),aged from 24 to 80 years old,with an average age of(54.2±10.7).There were 111 cases in the TEVAR group and 128 cases in the TEVAR+RBS group.Technical success rate 100%.The incidence of distal induced New entry(dSINE)of TEVAR+RS group was significantly lower than that of the TEVAR group[14/111(12.6%)vs.2/128(1.6%),P=0.0007],and the reconstruction of false aortic cavity was also significantly better than that of the TEVAR group.Conclusions:The application of thoracic aortic endovascular repair combined with restrictive stent(RS)in the treatment of B-type aortic dissection can not only effectively reduce dSINE occurrence,but also be beneficial to the reconstruction of the false cavity of aortic dissection,with good median-long-term efficacy.

关 键 词：主动脉夹层 主动脉腔内修复术 支架源性新发破口 限制性支架 

分 类 号：R54[医药卫生—心血管疾病]