目的:探讨带膜支架腔内隔绝术治疗B型主动脉夹层的技术方法及疗效。方法:对近年我院收治的40例主动脉夹层进行分析。40例患者均行股动脉穿刺插管至升主动脉造影,了解主动脉真假腔、夹层裂口及其与重要血管分支位置关系。切开右或左侧股动脉置入覆膜血管内支架,封堵原发破口,置入支架后重复造影检查。观察真假腔血流变化、主动脉分支供血的情况。结果:40例患者支架置入定位准确,术后即刻造影显示真腔血流恢复正常。手术成功率100%,无术中转开胸手术,无截瘫及瘤体破裂等严重并发症,无围手术期死亡。所有患者术后3~6个月复查增强CT,假腔不再显影,支架通畅,无扭曲、移位。结论:带膜支架腔内隔绝术治疗B型主动脉夹层具有创伤小,术后恢复快,手术死亡率低,手术成功率高的优点,但远期效果有待进一步观察。
Citation:
ZHANG Renyu,YANG Jian,YANG Fan,et al.. Endovascular Stentgraft For Treating Type B Aortic Dissection in Forty Cases. West China Medical Journal, 2009, 24(1): 50-52. doi:
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- 1. NienaberCA,FattoriR,Lund G,et al. Nonsurgical reconstruction of thoracic dissection by stentgraftplacement[J].N Engl JMed,1999,340(20):1539-1545..
- 2. 邸龙辉,荆全民.Stanford B型主动脉夹层治疗新进展[J].中国实用内科杂志,2007,27(22):1796-1798.
- 3. Svensson LG.New and future approaches for spinal cord protection[J].Semin Thorac Cardiovasc Surg,1997,9(3):206-221..
- 4. 景在平.主动脉夹层的诊断和腔内隔绝术应用指南(初稿)[J].中国实用外科杂志,2004,24(3):129-133..
- 5. Wang ZG,LiC.Singlebranch endograft for treating stanford type B dissectionswith entry tears in proximity to the left subclavian artery[J].J Endovasc Ther,2005,12 (5):588-593..
- 6. 刘正军,陈尔瑜.临床解剖学丛书胸部和脊柱分册[M].北京:人民卫生出版社,1991:380-382.
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- 8. Schurink GW,Aarts NJ,vanBockel JH.Endoleak after stentgraft treatment of abdominal aortic aneurysm:a metaanalysis of clinical studies[J].Br J Surg,1999,86:581-587..
- 9. 汪忠镐,陈学明,余军,等.支架型人工血管治疗主动脉夹层动脉瘤[J].中国普通外科杂志,1999,8:403-405..
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