Castor单分支支架治疗近端锚定区不足的Stanford B型主动脉夹层  

Castor single-branch stent in treating Stanford type B aortic dissection with insufficient anchorage zone

作　　者：裴长安[1] 胡潍青[1] 尚遂源 汲武广[1] 孙波[1] 张纪存 曹广信[1] 刘涛[1] 姜炎杰 张杰峰[1] Pei Chang'an;Hu Weiqing;Shang Suiyuan;Ji Wuguang;Sun Bo;Zhang Jicun;Cao Guangxin;Liu Tao;Jiang Yanjie;Zhang Jiefeng(Department of Vascular Surgery,Weifang People's Hospital,Weifang 261000,China)

机构地区：[1]潍坊市人民医院血管外科,潍坊261000

出　　处：《中华普通外科杂志》2022年第10期766-769,共4页Chinese Journal of General Surgery

基　　金：潍坊市卫生健康委员会科研项目(WFWSJK-2020-268)。

摘　　要：目的研究Castor单分支主动脉覆膜支架治疗锚定区不足的Stanford B型主动脉夹层(TBAD)的临床效果。方法回顾性分析2019年4月—2021年9月潍坊市人民医院收治的使用Castor支架治疗的TBAD患者25例,入选病例近端健康锚定区均≤15 mm,根据术前CTA检查及术中造影选择支架型号,记录手术情况及随访结果。结果手术成功率为100%,平均手术时间(137.8±35.8)min,平均出血量(52.8±24.5)ml,术中内漏2例,经球囊扩张贴附后内漏消失,分支支架狭窄2例,经球囊扩张后狭窄消失。中位随访时间14.6个月,随访期间分支支架通畅率为100%,术后3个月胸主动脉真腔直径较术前明显扩大,假腔直径较术前明显缩小(P<0.05)。结论应用Castor支架治疗近端锚定区不足的TBAD简单易行,近期临床效果满意。Objective To evaluate Castor single-branch covered-stent in the treatment of Stanford B aortic dissection(TBAD)with insufficient anchorage zone.Methods Clinical data of 25 TBAD patients(proximal healthy landing zone≤15 mm)treated with Castor branched stent-graft at Weifang People's Hospital from Apr 2019 to Sep 2021 were analyzed retrospectively.The stent model was selected according to preoperative CTA examination and intraoperative angiography,the operation result and follow up data were reviewed.Results The operation success rate was 100%,the mean operative time was(137.8±35.8)min,and the mean blood loss was(52.8±24.5)ml.There were 2 cases of internal leakage(IA)and it was disappeared after balloon dilation,Branched stent stenosis occurred in 2 cases and relieved by balloon dilatation.The mean follow-up time was 14.6 months,and the patency rate of branch stent was 100%during the follow-up period.The true lumen diameter of thoracic aorta was significantly expanded and the false lumen diameter was significantly reduced 3 months after surgery compared with that before surgery(P<0.05).Conclusion Castor stenting in the treatment of TBAD with insufficient proximal anchoring area is simple and feasible,with satisfactory short term clinical effect.

关 键 词：主动脉疾病 支架 左锁骨下动脉 主动脉腔内修复术 

分 类 号：R654.3[医药卫生—外科学]