管腔内支架人工血管治疗降主动脉夹层

The treatment of descending aortic dissection with endovascular stent-grafts

目的探讨应用腔内支架人工血管植入治疗DeBakeyⅢ型降主动脉夹层的适应证、操作技巧及并发症防治。方法对7例DeBakeyⅢ型降主动脉夹层在全麻下行腔内支架人工血管植入术,经左上肢置入造影导管造影,经股动脉导入支架人工血管植于夹层破口处封闭破裂口。结果7例共植入支架人工血管8只,1例发生内漏,经加放1只支架人工血管封堵成功。操作成功率100%,无手术死亡。近期、中期效果良好。结论支架人工血管植入术治疗DeBakeyⅢ型降主动脉夹层具有创伤小,恢复快的特点,尤其适用于体质差、有合并症及外科手术禁忌的患者,近期效果良好,远期效果有待进一步观察。

Objective To explore the operative indication,operative skill and the prevention of complications of endovascular stent-grafting for Debakey Ⅲ descending aortic dissection.Methods 7 cases with Debakey Ⅲ descending aortic dissection received endovascular stent-grafting under general anesthesia.Aortic angiograph was obtained via an angiographic catheter in the subclavian artery inserted from the radial artery.Stent-grafts were placed to the entry site of descending aortic dissection via femoral artery.Results 8 stent-grafts were used 7 cases with 1 stent-grafts for 1 cases because of the perigraft leakage.All the operations were successful with excellent recoveries.Conclusion Endovascular stent-grafting for Debakey Ⅲ descending aortic dissection is an acceptable method,especially for those who cannot receive standard surgical procedures due to severe comorbidities.The short and mid-term results are excellent,whereas long-term results have to be awaited to evaluate the real effectiveness of this method.