Stanford B型主动脉夹层合并迷走右锁骨下动脉的杂交治疗  

Hybrid endovascular repair for type B aortic dissection combined with aberrant right subclavian artery

作　　者：席志龙 仇冰梅 王常田 张雷 李德闽 XI Zhilong;QIU Bingmei;WANG Changtian;ZHANG Lei;LI Demin(Department of Cardiothoracic Surgery,General Hospital of Eastern Theater Command,PLA,Nanjing 210002,Jiangsu,China)

机构地区：[1]东部战区总医院心胸外科,南京210002

出　　处：《东南国防医药》2023年第1期50-53,共4页Military Medical Journal of Southeast China

摘　　要：目的总结并探讨合并迷走右锁骨下动脉(ARSA)的Stanford B型主动脉夹层的治疗策略。方法回顾性分析2015年1月至2022年1月东部战区总医院收治的合并ARSA的Stanford B型主动脉夹层5例患者的临床资料和治疗结果。结果5例患者均行杂交治疗,先行升主动脉-左、右锁骨下动脉血管旁路,再行胸主动脉腔内修复术(TEVAR)。术后均痊愈出院,平均住院(13.4±4.3)d,围术期及随访期间无死亡、内漏、头颅及上肢缺血等并发症。结论杂交手术是治疗合并ARSA的Stanford B型主动脉夹层的有效手段,临床疗效满意。Objective To summarize and discuss the therapy of type B aortic dissection combined withaberrant right subclavian artery.Methods The clinical and image data of 5 patients,who suffered from type B aortic dissection combined with aberrant right subclavian artery admitted to the Eastern Theater General Hospital from January 2015 to January 2022,were retrospectively analyzed.Results All of the 5 cases received hybrid endovascular repair.Before the thoracic endovascular aortic repair(TEVAR),supra-aortic bypass to all aortic branches involved was rebuilt.The average hospital stay was(13.4±4.3)days.All patients were successfully discharged during the perioperative and follow-up periods,without endoleak,upper limb ischemia or nervous system complications.Conclusion For type B aortic dissection combined with aberrant right subclavian artery,hybrid endovascular repair is a safe treatment strategy and lead to satisfactory clinical outcome,which can effectively avoid upper limb ischemia and nervous system complications after operation.

关 键 词：B型主动脉夹层 迷走右锁骨下动脉 杂交治疗 

分 类 号：R654.3[医药卫生—外科学]