目的 总结采用覆膜支架腔内隔绝术治疗Stanford B型主动脉夹层的临床经验。 方法 2008年8月至2012年10月安庆市立医院对26例Stanford B型主动脉夹层患者行覆膜支架腔内隔绝术治疗,男21例,女5例;年龄(52.4±10.3)岁。术后定期复查CT血管成像。 结果 所有患者支架释放全部成功,无死亡、中转开胸和截瘫。术后发现支架覆盖腹腔干及肠系膜上动脉1例,急诊行旁路移植术;多发性脑梗塞1例,轻度Ⅰ型内漏2例,未予特殊处理;股动脉狭窄3例,其中1例严重狭窄者行大隐静脉移植术,2例中度狭窄者给予保守治疗。随访22例,随访时间(23.5±15.9)个月。随访期间CT血管成像显示所有患者支架无移位,主动脉真腔较术前明显扩大,假腔血栓形成。 结论 覆膜支架腔内隔绝术创伤小、效果佳、并发症少,是治疗Stanford B型主动脉夹层的有效方法。
Citation:
詹必成,刘建,杜少鸣,张凡,陈剑. 覆膜支架腔内隔绝术治疗Stanford B型主动脉夹层. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2013, 20(3): 360-361. doi: 10.7507/1007-4848.20130106
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Rehders TC, Petzsch M, Ince H, et al. Intentional occlusion of the left subclavian artery during stent-graft implantation in the thoracic aorta:risk and relevance. J Endovasc Ther, 2004, 11 (6):659-666.
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Buffolo E, da Fonseca JH, de Souza JA, et al. Revolutionary treatment of aneurysms and dissections of descending aorta:the endovascular approach. Ann Thorac Surg, 2002, 74 (5):1815-1817.
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景在平, 冯翔, 包俊敏, 等. 腔内隔绝术治疗Standford B型主动脉夹层-116例临床分析. 中国胸心血管外科临床杂志, 2003, 14 (1):14-18.
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Hata M, Shiono M, Inoue T, et al. Optimal treatment of type B acute aortic dissection:long-term medical follow-up results. Ann Thorac Surg, 2003, 75 (6):1781-1784.
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Yang CP, Hsu CP, Chen WY, et al. Aortic remodeling after endova- scular repair with stainless steel-based stent graft in acute and chronic type B aortic dissection. J Vasc Surg, 2012, 55 (6):1600-1610.
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Lu Q, Jing Z, Zhao Z, et al. Endovascular stent graft repair of aortic dissection type B extending to the aortic arch. Eur J Vasc Endovasc Surg, 2011, 42 (4):456-463.
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张宏家, 刘愚勇, 李海洋, 等. 覆膜支架腔内隔绝术治疗主动脉夹层动脉瘤121例. 中华胸心血管外科杂志, 2007, 23(3):175-177.
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- 1. Rehders TC, Petzsch M, Ince H, et al. Intentional occlusion of the left subclavian artery during stent-graft implantation in the thoracic aorta:risk and relevance. J Endovasc Ther, 2004, 11 (6):659-666.
- 2. Buffolo E, da Fonseca JH, de Souza JA, et al. Revolutionary treatment of aneurysms and dissections of descending aorta:the endovascular approach. Ann Thorac Surg, 2002, 74 (5):1815-1817.
- 3. 景在平, 冯翔, 包俊敏, 等. 腔内隔绝术治疗Standford B型主动脉夹层-116例临床分析. 中国胸心血管外科临床杂志, 2003, 14 (1):14-18.
- 4. Hata M, Shiono M, Inoue T, et al. Optimal treatment of type B acute aortic dissection:long-term medical follow-up results. Ann Thorac Surg, 2003, 75 (6):1781-1784.
- 5. Yang CP, Hsu CP, Chen WY, et al. Aortic remodeling after endova- scular repair with stainless steel-based stent graft in acute and chronic type B aortic dissection. J Vasc Surg, 2012, 55 (6):1600-1610.
- 6. Lu Q, Jing Z, Zhao Z, et al. Endovascular stent graft repair of aortic dissection type B extending to the aortic arch. Eur J Vasc Endovasc Surg, 2011, 42 (4):456-463.
- 7. 张宏家, 刘愚勇, 李海洋, 等. 覆膜支架腔内隔绝术治疗主动脉夹层动脉瘤121例. 中华胸心血管外科杂志, 2007, 23(3):175-177.