摘要
目的介绍应用带膜血管腔内支架植入术治疗Stanford B型胸主动脉夹层的方法和效果。方法对29例（男25例，女4例，年龄38-77岁）胸主动脉夹层动脉瘤腔内隔绝术患者的临床资料进行回顾性分析。术前采用CT血管成像（CTA）、磁共振血管成像（MRA）技术或CT对主动脉夹层动脉瘤进行评估，术前穿刺左肱动脉行升主动脉对比剂追踪了解破口的位置及撕裂的范围，所有的患者都在全麻下进行的，术中在数字减影血管造影机监视下经股动脉或髂动脉将带膜支架导人胸主动脉封闭夹层破口。结果29例均成功进行了胸主动脉夹层的血管腔内隔绝术，其中25例使用Talent支架，4例为国产支架。术后主动脉造影证实夹层裂口完全封闭或内漏明显减少，无中转开胸手术，围手术期无死亡及严重并发症发生。术后随访3～29个月（平均15个月），其中21例行CT复查，8例行DSA复查，3例病人在术后2～8个月行心脏瓣膜置换术。结论带膜支架腔内隔绝术是治疗胸主动脉夹层动脉瘤的简便安全而有效的方法，近期疗效好。手术死亡率和并发症发生率低，手术成功率和生存率高。
Objective To introduce the techniques and effects of endovascular stent-graft exclusion in the treatment of thoracic aortic dissection aneurysm （Stanford B）. Methods Endovascular stent-graft exclusion was performed in 29 patients with thoracic aortic dissection aneurysm （Stanford B） （the range of age was from 38 to 77 years, 25 male and 4 female）. Computed tomography angiography （CTA）, magnetic resonance angiography （MRA） or CT was used as a preoperative evaluation methods. The position and extent of the thoracic aortic dissection aneurysm were analyzed through angiography. All of the 29 patients accepted the operations under general anesthesia. The stent-grafts were inserted from the femoral or iliac artery to exclued the aneurysm, and all operations were performed under DSA guidance. Results Endovascular stent-graft exclusion was successfully performed in all 29 patients, Talent stent was used in 25 cases, the other 4 accepted the home-made stents. After operation, angiography of aorta showed the dissection aneurysm was excluded absolutely, or the inner leak reduced obviously. No patient had to appeal to thoracic surgery, and no perioperative death or serious complication happened. The range of postoperative follow-up was form 3 to 29 months （average 15 months）. Twenty-one of the patients accepted a reexamination of CT, 8 of them were performed DSA at the same time. 3 patients accepted valve replacement about 2-8 months after operation. Conclusion Endovascular graft exclusion is a simple, secure and effective way to treat thoracic aortic dissection aneurysm, the rate of death and complications caused by this operation is low, and a famous rate of success and survival could be acquired after the operation.
出处
《中国介入影像与治疗学》
CSCD
2006年第2期130-133,共4页
Chinese Journal of Interventional Imaging and Therapy
关键词
动脉瘤
腔内隔绝术
支架
夹层
Aneurysm
Endovascular graft exclusion
Stent
Dissection
