主动脉覆膜支架腔内隔绝治疗Stanford A型主动脉夹层临床效果  

Clinical effect of endovascular isolation treatment by using aortic covered stent for Stanford type A aortic dissection

作　　者：张胜康[1] 尹晓清[1] 徐朝军[1] 王兆礼[1] 杨进[1] 程宇[1] ZHANG Shengkang;YIN Xiaoqing;XU Zhaojun;WANG Zhaoli;YANG Jin;CHENG Yu(Deparment of Cardiothoracice Surgery,First Affliated Hospital of Hunan Uninersity of Traditional Chinese Medine,Changsha,Hunan Province 410007,China)

机构地区：[1]湖南中医药大学第一附属医院心胸外科,长沙410007

出　　处：《介入放射学杂志》2022年第9期894-897,共4页Journal of Interventional Radiology

基　　金：湖南省教育厅科学研究项目(20A364);湖南省高等学校“国内一流建设学科”项目(湘教通2018-469)。

摘　　要：目的 探讨应用主动脉覆膜支架腔内隔绝术治疗Stanford A型主动脉夹层的临床效果。方法 回顾性分析2016年6月至2018年10月在湖南中医药大学第一附属医院接受主动脉弓部开窗支架技术全腔内隔绝升主动脉、主动脉弓及降主动脉近段治疗的14例Stanford A型主动脉夹层患者临床资料。观察术后随访1年临床疗效。结果 14例患者均顺利完成手术。术后1年5例治疗效果理想。术后早期死亡1例,支架近端再发夹层4例,发生Ⅰ型、Ⅱ型内漏各1例,Ⅲ型2例。结论 对于不能外科修复的A型主动脉夹层,可谨慎选择主动脉弓部开窗支架技术行全腔内修复治疗,但须根据患者自身情况和血管病变特点严格把握适应证。Objective To investigate the clinical effect of endovascular isolation treatment by using aortic covered stent for Stanford type A aortic dissection. Methods From June 2016 to October 2018 at the First Affiliated Hospital of Hunan University of Traditional Chinese Medicine of China, a total of 14 patients with Stanford type A aortic dissection received endovascular complete isolation treatment of ascending aorta,aortic arch and proximal descending aorta by using aortic covered stent implantation with the help of extracorporeal aortic arch fenestration technique. The clinical data were retrospectively analyzed. The patients were followed up for one year to observe the short-term and mid-term effects. Results Successful surgery was accomplished in all the 14 patients. One year after surgery, ideal therapeutic effect was obtained in 5 patients.After surgery, early death was seen in one patient, recurrent dissection at the aorta proximal to the stent occurred in 4 patients, and one patient developed type I endoleak, one patient developed type Ⅱ endoleak,and 2 patients developed type Ⅲ endoleak. Conclusion For Stanford type A aortic dissection that cannot be surgically repaired, endovascular complete isolation treatment by using aortic covered stent implantation with the help of extracorporeal aortic arch fenestration technique can be carefully employed, but, based on the patient’s clinical condition and the characteristics of the vascular lesions, the indications of this therapy must be strictly observed.(J Intervent Radiol, 2022, 31: 894-897)

关 键 词：Stanford A型主动脉夹层 主动脉覆膜支架 体外开窗 血管腔内修复 

分 类 号：R654.3[医药卫生—外科学]