单中心TEVAR治疗累及弓部的Stanfrod B型主动脉夹层的疗效分析  

Analysis of the efficacy of single-center TEVAR in the treatment of Stanfrod type B aortic dissection involving the arch

作　　者：张华[1] 陈思 蒋福东 刘新波[1] 王瑶婕 李有金[1] ZHANG Hua;CHEN Si;JIANG Fudong;LIU Xinbo;WANG Yaojie;LI Youjin(People′s Hospital of Ningxia Hui Autonomous Region,Yinchuan 750002,China)

机构地区：[1]宁夏回族自治区人民医院,宁夏银川750002

出　　处：《宁夏医学杂志》2024年第10期837-840,F0002,共5页Ningxia Medical Journal

基　　金：宁夏重点研发计划项目(2022BEG02030);宁夏自然科学基金项目(2023AAC03454)。

摘　　要：目的探讨胸主动脉腔内修复术(TEVAR)治疗累及弓部的Stanfrod B型主动脉夹层的安全性及有效性。方法回顾性分析收治的53例病变累及主动脉弓部的Stanfrod B型主动脉夹层患者的一般资料,合并疾病、手术方式、术后并发症及再干预情况,以及其近期效果。结果53例患者均经腔内修复治疗,其中TEVAR+LSA单开窗(未重建)12例,TEVAR+LSA单开窗(重建)22例,TEVAR+LCCA+LSA双开窗(重建)2例,TEVAR+BCT+LCCA+LSA三开窗(重建)1例,TEVAR+LSA平行支架7例,TEVAR+单分支支架重建(Castor支架)9例。围术期并发症发生率为5.7%,逆撕为A型夹层1例,截瘫1例,肱动脉假性动脉瘤1例;围术期死亡1例,死亡率为1.9%。结论TEVAR治疗累及弓部的Stanfrod B型主动脉夹层安全有效,创伤小、恢复快,近期效果令人满意,中、远期效果仍需继续随访观察。Objective To investigate the safety and efficacy of thoracic aortic endoluminal repair(TEVAR)in the treatment of Stanfrod type B dissection involving the arch.Methods A retrospective analysis was performed for the general data,combined diseases,surgical methods,postoperative complications and re-intervention of 53 patients with Stanfrod type B aortic dissection involving the aortic arch,as well as their short-term effects.Results All 53 patients were treated with endovascular repair,including 12 cases of TEVAR+LSA single fenestration(unreconstructed),22 cases of TEVAR+LSA single fenestration(reconstruction),2 cases of TEVAR+LCCA+LSA double fenestration(reconstruction),1 case of TEVAR+BCT+LCCA+LSA triple fenestration(reconstruction),7 cases of TEVAR+LSA parallel stents,and 9 cases of TEVAR+single-branch stent reconstructions(Castor stents).The perioperative complication rate was 5.7%,and the reverse tear was one case of type A dissection,1 case of paraplegia,and 1 case of brachial artery pseudoaneurysm.There was one perioperative death,with a mortality rate of 1.9%.Conclusion TEVAR for Stanfrod type B aortic dissection involving the arch is safe and effective,with minimal trauma and fast recovery,and the short-term effect is satisfactory,and the medium-and long-term effect still needs to be followed up and observed.

关 键 词：TEVAR 累及弓部 Stanford B型夹层 

分 类 号：R654[医药卫生—外科学]