覆膜支架腔内隔绝术治疗Stanford B型夹层动脉瘤

Endovascular Stent-Graft Exclusion for Aortic Dissections

目的:探讨Stanford B型主动脉夹层动脉瘤腔内治疗的手术指征、术前评估方法、手术操作技巧、并发症防治原则及临床应用前景。方法:回顾分析68例行Stanford B型主动脉夹层动脉瘤腔内隔绝术患者的临床资料,术前采用CT血管造影对主动脉夹层动脉瘤进行评估,术中在数字减影血管造影监视下经股动脉或髂动脉将移植物导入胸主动脉封闭夹层裂口。结果:术中移植物全部释放成功,术后患者疼痛基本消失,无血栓栓塞、截瘫、器官缺血、吻合口狭窄、动脉瘤及支架移位等并发症。结论:覆膜支架腔内隔绝术是一种治疗Stanford B型主动脉夹层动脉瘤的有效方法,其手术创伤小、术后恢复快,疗效好、安全性高。

Objective：To assess the operation indications,preoperative evaluation,techni- que essentials and clinical prospect of endovascular stent-graft exclusion for aortic dissection.Methods：From December 2008 to October 2010,endovascular stent-graft exclusion for aortic dissection was preformed in 68 patients.CTA was used as preoperative evaluation methods.Graft was constructed from self-expanding Z-stents covered with a woven Dacron polyester fabric graft.The stent-grafts were inserted from the femoral or iliac artery to exclude the tear of dissection,and all operations were performed under DSA guidance.Results： The grafts were all installed successfully in 68patients,chest complaint was disappeared,No accidents such as thromboembolism, paraplegina,ischemia,aneurysm occurred.Conclusions：Endovascular thoracic aorta repair is an effectiveness invasive and safe surgery for patients with Stanford B aortic dissection and traumatic aortic rupture.