一体式分支型覆膜支架治疗Stanford B型主动脉夹层的疗效分析  

Analysis of the effect of one-piece branched stent-graft in the treatment of Stanford type B aortic dissection

作　　者：蔡顺然 宋凯 陈文忠[1] 闫志国[2] 苏尔育 朱灏 Cai Shunran;Song Kai;Chen Wenzhong;Yan Zhiguo;Su Eryu;Zhu Hao(Department of Intervention,Kunming First People's Hospital,Kunming 650000,Yunnan,China;Department of Cardiothoracic Surgery,Kunming First People's Hospital,Kunming 650000,Yunnan,China)

机构地区：[1]昆明市第一人民医院介入科,云南昆明650000 [2]昆明市第一人民医院心胸外科,云南昆明650000

出　　处：《血管与腔内血管外科杂志》2023年第8期931-934,共4页Journal of Vascular and Endovascular Surgery

基　　金：昆明市卫生健康委员会卫生科研课题项目(2021-09-04-002)。

摘　　要：目的探讨一体式分支型覆膜支架对近端正常血管锚定区不足的Stanford B型主动脉夹层(AD)的疗效。方法收集2020年1月至2021年10月于昆明市第一人民医院进行治疗的18例Stanford B型AD患者的临床资料,观察支架的位置、术后支架通畅情况、主动脉修复情况及术后相关并发症的发生情况。结果18例患者的手术均获得成功。术后1周、3个月分支支架通畅率均为100%。术后3个月主动脉真腔直径均较术前明显增大,主动脉假腔直径均较术前明显缩小(P<0.01),假腔完全血栓化率为66.7%(12/18)。术后住院期间及随访期间无脑卒中、截瘫及死亡患者,Ⅰ型内漏患者1例。结论一体式分支型覆膜支架治疗近端正常血管锚定区不足的Stanford B型AD的疗效显著,手术时间短,操作相对简便,支架通畅率较高,并发症发生率较低,有利于临床应用。Objective To investigate the curative effect of one-piece branched stent-graft on Stanford type B aortic dissection(AD)with insufficient proximal normal vessel anchoring zone.Method The clinical data of 18 Stanford type B AD patients treated in Kunming First People's Hospital from January 2020 to October 2021 were collected.The position of the stent,postoperative branch stent patency,aortic repair,and related complications were observed.Result The operations of 18 patients were all successful.The patency rate of branch stents was 100% in the first week and third month after the operation.In the third month after the operation,the diameter of the aortic true lumen was significantly larger than that before the operation,and the diameter of the aortic false lumen was significantly smaller than that before the operation(P<0.01),and the rate of complete thrombosis of the false lumen was 66.7%(12/18).During postoperative hospitalization and follow-up period,there was no stroke,paraplegia,or death,while one case of type I endoleak was reported.Conclusion The one-piece branched stent-graft has a remarkable effect in the treatment of Stanford B type AD with insufficient proximal normal vessel anchoring area,and the operation time is short and relatively simple,the stent patency rate is high,and the incidence of complications is low,which is beneficial to clinical application.

关 键 词：主动脉夹层 分支型覆膜支架 血管腔内治疗 疗效 并发症 

分 类 号：R543[医药卫生—心血管疾病]