Stanford B型主动脉夹层腔内隔绝术后远期并发症

Delayed complications after endovascular exclusion for Stanford Type B aortic dissections

目的：报告腔内隔绝术治疗Stanford B型主动脉夹层的远期并发症,评价这一疗法的远期效果并对腔内移植物的设计提出改进意见。方法：对一组146例Stanford B型夹层行腔内隔绝术后,经随访3至8年,统计其术后24个月以上出现的并发症。结果：该组远期并发症包括支架型移植物远端处夹层隔膜破裂5例；肾下腹主动脉段假腔增大2例；再发Stanford A型夹层3例；移植物破损2例。结论：虽然腔内隔绝术治疗Stanford B型主动脉夹层的远期效果总体比较满意,但腔内移植物的设计仍有改进的必要,特别是针对移植物远端隔膜破裂和远期移植物破损的问题。

Objective To review the delayed complications after endovascular exclusion for Stanford type B aortic dissections, and to evaluate the long-term efficacy and the necessity of endograft modification. Methods A total of 146 cases of Stanford type B aortic dissections that underwent endovascular procedures were followed up for 36 to 96 months. Complications that occurred in 24 months after operation were recorded. Results Delayed complications after endovasculax exclusion were： internal spectrum rupture at the distal edge of the endograft, 5 cases; progressive dilatation of infra-renaf abdominal aorta, 2 cases; Stanford type A dissection, 3 cases; and erosion of endograft, 2 cases. Conclusions Even though the endovascular exclusion procedure for Stanford type B aortic dissection produced relatively satisfactory long-term results, improvement in endograft designing is needed in order to reduce stem-graft induced internal spectrum rupture and graft erosion.