腔内修复术治疗Stanford B型主动脉夹层

Endovascular repair for Stanford type B aortic dissection

目的探讨Stanford B型主动脉夹层腔内修复术治疗经验。方法从2002年5月-2007年10月，对多病并存的8例Stanford B型主动脉夹层患者在选择性动脉造影动态监控下施行了腔内主动脉修复术。移植物大小根据螺旋CT动脉造影测量确定。结果8例腔内修复术均操作成功，其中2例小内漏术后早期随访内漏消失。8例随访1～66个月，螺旋CT扫描提示血管内移植物无移位。结论螺旋CT是在主动脉夹层诊断及术后随访中应用最为广泛的无创技术。腔内主动脉修复术后内漏的处理至关重要。腔内主动脉修复术治疗Stanford B型主动脉夹层安全可靠，有良好的应用价值。腔内修复术这一微创治疗方式特别适用于高龄、有伴随疾病等增加开放手术风险的患者。

Objective To assess the experience of endovascular repair（EVR） in treatment of Stanford type B aortic dissection （AD）. Methods Since May 2002, EVAR for type B aortic dissection had been performed on 8 patients with other disease. All operations were performed under DSA guidance. Graft dimensions were determined by spiral computed tomography. Results Procedures in all the 8 patients were successfully performed. Small endoleak in 2 patients disappeared in the early follow-up duration, migration of graft were not determine by spiral computed tomography in the 1-66 months follow-up duration. Conclusion Spiral computed tomography is the nost widely used noninvasive technique in diagnosis and postoperative follow-up on aortic dissection. It is very important for treatment of postoperative endoleak. EVR is a safe and effective treatment for Stanford type B aortic dissection. This less invasive approach may be of particular value for elderly patients or patients with coexisting conditions that would increase the risk of conventional surgical treatment.