累及左锁骨下动脉Stanford B型主动脉夹层的腔内治疗进展  

Progress in endovascular treatment of Stanford type B aortic dissection involving the left subclavian artery

作　　者：张淼[1] 牛旭鹏 王梓彬 刘博宇 张磊[1] Zhang Miao;Niu Xupeng;Wang Zibin;Liu Boyu;Zhang Lei(Department of Vascular Surgery,the First Hospital of Hebei Medical University,Shijiazhuang 050000,Hebei,China)

机构地区：[1]河北医科大学第一医院血管外科,河北石家庄050000

出　　处：《血管与腔内血管外科杂志》2024年第12期1454-1458,共5页Journal of Vascular and Endovascular Surgery

摘　　要：主动脉夹层是一种致命的心血管疾病。对于Stanford B型主动脉夹层,主动脉腔内隔绝术(TEVAR)是目前首选的治疗方法,其侵入性远低于开放手术。标准的TEVAR是使用支架移植物覆盖近端破口,可以防止假腔扩张并促进其血栓形成,进而达到治疗效果。在植入血管内移植物的过程中,左锁骨下动脉(LSA)覆盖与多种并发症的发生有关,包括脑卒中、脊髓缺血和上肢缺血等,因此,主动脉弓部疾病腔内治疗的关键在于保留或重建弓上分支动脉。目前,国内大部分医疗中心倾向于重建LSA。本文对TEVAR中重建LSA的原因、方法及优缺点进行综述,以及对未来重建弓上动脉进行展望。Aortic dissection is a fatal cardiovascular disease.For Stanford type B aortic dissection,thoracic endovascular aortic repair(TEVAR)is the preferred treatment and it is much less invasive than open surgery.Standard TEVAR uses a stent graft to cover the proximal tear,which can prevent the pseudocavity from expanding and promotes thrombosis,thereby achieving therapeutic results.Coverage of the left subclavian artery(LSA)during endovascular graft implantation is associated with multiple complications,including stroke,spinal cord ischemia,and upper limb ischemia.The key to endovascular treatment of aortic arch disease is to preserve or reconstruct the suprarcuate artery.Currently,most medical centers in the country tend to rebuild LSA.This article provides a review of the reasons,methods,advantages,and disadvantages of reconstructing LSA in TEVAR,as well as the prospects of future reconstruction of the superior arch artery.

关 键 词：Stanford B型主动脉夹层 主动脉腔内隔绝术 左锁骨下动脉 重建弓上动脉 

分 类 号：R543[医药卫生—心血管疾病]