腔内修复术治疗胸腹主动脉瘤

Endovascular repair of thoracoabdominal aortic dissection and abdominal aortic aneurysm

目的 探讨胸腹主动脉瘤腔内修复术的手术指征、存在问题及应用前景。方法 2 0 0 2年 5月～ 2 0 0 4年 8月 ,对多病并存的 3例胸腹主动脉瘤患者在全麻和选择性动脉造影动态监控下施行了腔内主动脉修复术。结果 3例均为男性 ,年龄 39～ 83岁。其中StanfordB型胸腹主动脉夹层 2例 ,腹主动脉瘤 1例。其中 2例经腔内人工血管支架修复后动脉夹层消失 ,1例腹主动脉瘤消失。 3例随访 1～ 2 4个月 ,螺旋CT提示血管内移植物无移位。结论 腔内主动脉修复术操作简便 ,疗效可靠 ,缩短了手术与住院时间 ,减少了手术风险及术后并发症 ,有良好的应用价值。

Objective To explore the indications,methods, problems and clinical prospects of endovascular repair(EVR) of aortic dissection and abdominal aortic aneurysm(AAA).Methods Under general anesthesia and dynamic supervision of DSA, an endovascular aortic repair (EVAR)with a stent-graft complex was successfully performed on 3 men with aortic dissection or AAA. Results There were 3 male patients aged 39-83 in this series.Of them,2 cases with Stanford type B thoracoabdominal aortic dissection (TAD), and one with abdominal aortic aneurysm. Of the 3 patients,the dissection was disappeared completely after EVR in 2 cases;abdominal aortic aneurysm disappeared in one case.During 1-24 months follow-up, postoperative spiral CT showed no endovascular graft migration. Conclusion EVAR-treated patients have fewer complications,lower risks and shorter in-hospital stays than those treated with open-repair surgery.Endovascular aortic repair is of great practical value.