国产覆膜支架腔内修复术治疗主动脉病变(附30例临床分析)

Domestic-made stent-graft placement for the treatment of aortic diseases:report of 30 cases

目的探讨国产覆膜支架腔内修复术治疗主动脉夹层、主动脉创伤和动脉瘤的安全性、有效性。方法应用国产覆膜支架腔内修复术治疗胸主动脉夹层动脉瘤23例(均属Stanford B型);胸主动脉峡部外伤后裂口伴假性动脉瘤形成1例;肾下腹主动脉瘤6例,其中1例选择应用连体带膜支架移植系统,另1例选择单臂带膜支架释放系统和对侧髂总动脉封堵系统,联合股-股动脉人工血管旁路转流术。结果手术治疗均获得成功。死亡2例,1例Stanford B型,术后24小时内死于夹层破裂;另1例主动脉夹层术后第3天死于心肌梗死。28例病人随访疗效满意。结论国产覆膜支架腔内修复术治疗主动脉夹层、主动脉创伤和动脉瘤安全、成功率高、创伤小。

Objective To investigate the feasibility of domestic-made stent-graft placement for the treatment of aortic dissection, injury and aneurysm. Methods Domestic-made stent-grafts were placed in 23 cases with thoracic aortic dissection （Stanford B）, 1 case of isthmus injury with pseudo-aneurysm formation, 6 cases of infra-renal abdominal aortic aneurysms, one of which was implanted with bifurcated stent-graft, another with one-limb stent-graft placement plunging occlusion combined with femoro-femoral cross-over bypass. Results Technical success was achieved in all patients. One patient died in 24h after operation because of rupture of the dissection. Another one died of cardiac infarction 3 days after operation. The follow-ups for 28 patients were satisfing. Conclusion Domestic-made stent-graft placement for the treatment of aortic dissection, injury and aneurysm had a high successful rate and minimal invasiveness, which is of great importance in clinical application.