腔内隔绝术治疗Stanford B型主动脉夹层80例临床分析

Endovascular therapy of Stanford type B aortic dissection in 80 cases

目的总结应用腔内隔绝术治疗Stanford B型主动脉夹层经验,分析其临床特点和疗效。方法自2002年1月至2009年3月80例Stanford B型主动脉夹层患者接受腔内隔绝术治疗,对临床资料进行回顾性分析。所有患者术前接受CT血管造影或磁共振血管造影检查,术后1、6、12个月,及以后每年行胸部X线与螺旋CT或者多排CT检查,观察手术疗效以及有无内漏、移位或人工血管内支架塌陷等术后并发症。结果80例患者均成功释放支架,术后即刻造影示3例发生内漏,再次植入支架后内漏消失。术后3例围手术期死亡,无术后截瘫。随访1、3、6年的累积存活率分别为87.5%、79.4%、71.4%。结论腔内隔绝术治疗主动脉夹层创伤小,严重并发症少,住院时间短,近、中期疗效令人满意。

Objective To summarize the experiences of intraeavitary isolation operation for Stanford B type dissecting aneurysm of aorta, and analyze its clinical features and efficacy. Methods From January 2002 to March 2009,80 cases of Stanford B type aortic dissection patients received the intraeavitary isolation operation, their clinical data were retrospec- tively analyzed. All patients received preoperative CT angiography or magnetic resonance angiography, and chest X-ray and spiral or multi-slice CT examination at 1,6,12 months after operation and than annually, observing the effect of surgery and whether or not present postoperative complications such as internal hemorrhage due to trauma, displacement and endovascular stent grafting collapse. Results All of 80 cases released successfully stent. Immediate postoperative angiography showed that internal hemorrhage due to trauma occurred in three cases. The internal hemorrhage due to trauma disappeared When the stent was implanted again. Three patients died during perioperative period and no postoperative paraplegia occured. Following up 1,3,6 years ,the cumulative survival rates were 87. 5% ,79.4% ,71.4% ,respectively. Conclu- sion The advantage of intracavitary isolation operation for Stanford B type dissecting aneurysm of aorta includes less trauma less serious complications, short hospitalization time satisfying, short-term and medium-term efficacy are satisfactory.