血管腔内隔绝术治疗降主动脉夹层动脉瘤

Endovascular stent-graft exclusion for the treatment of descending aortic dissection

目的：探讨血管腔内隔绝术治疗降主动脉夹层动脉瘤的技术方法和疗效。方法：对10例降主动脉夹层动脉瘤患者的临床资料进行分析,其中2例为DeBakeyШa型,8例为DeBakeyШb型。1例夹层动脉瘤仅累及腹主动脉,合并真性动脉瘤。影像学资料显示全组有3例在不同部位有2个以上撕裂口。结果：1例腹主动脉混合型动脉瘤按腹主动脉瘤腔内隔绝术进行,2例将人工带膜支架封闭左锁骨下动脉口,另7例均顺利进行主动脉腔内隔绝术。随访2~16个月,全部病例均存活。结论：血管腔内置入带膜支架型人工血管是治疗主动脉夹层动脉瘤的简便、安全、有效的方法。

Objective：To study the technique and therapeutic effect of endovascular stent- graft exclusion for the treatment of descending aortic dissection. Methods： The clinical data of 10 patients with descending aortic dissection were retrospectively analyzed. DeBakey type Ⅲ a dissection was found in 2 patients, and DeBakey type Ⅲ b dissection in 8 patients. Only abdominal aorta was involved in one patient with real dissecting aneurysm. Three patients have two or more tear entries in different sites according to imaging. Results： The operation was conducted according to the procedure of endovascular stent - graft exclusion in one patient with abdominal aortic mixed aneurysm. The entrance of left subclavian artery was excluded with polyester - covered stent in 2 patients. The endovascular stent - graft exclusion was successfully performed in the rest 7 patients. During the follow - up period of 2 to 16 months, all patients survived well. Conclusion ： Endovascular stent - graft exclusion is simple, safe and effective for the treatment of descending aortic dissection.