应用国产覆膜支架治疗Stanford B型主动脉夹层动脉瘤

Therapy of Stanford B aortic dissecting aneurysm using China-made tectorial stent

目的:评价应用国产覆膜支架治疗B型主动脉夹层动脉瘤的安全性及临床疗效。方法:自2005-05～2009-12对38例Stanford B型主动脉夹层动脉瘤实施了腔内隔绝术。其中男29例,女9例;年龄(54±12)岁。经CT增强扫描或磁共振成像(MRI)确诊。切开左或右股动脉置入覆膜支架,封堵胸主动脉破裂口,置入后造影检查证实疗效,随访行CT或MRI检查。结果:支架置入全部成功,术后即刻造影36例无内漏,2例见少量内漏。降主动脉及腹主动脉真腔均明显扩大,远端降主动脉及分支供血均有不同程度改善。住院期间及随访1年内无患者死亡,发生主动脉腔内隔绝术后综合征3例。结论:应用国产覆膜支架腔内隔绝治疗B型主动脉夹层动脉瘤是一种操作简便、安全、成功率高、并发症少,疗效可靠的介入方法。

Objective：To evaluate the safety and clinical efficacy of endovascular type B（Stanford B） aortic dissecting aneurysm by China-made tectorial stent.Methods：From May 2005 to December 2009,38 patients with type B aortic dissection included 29 men and 9 women with the mean age of 54±12 years old underwent stent graft implantation.All patients were diagnosed by contrast enhanced CT or MRI.Vascular access was obtained through femoral artery after surgical arteriotomy and stent graft was deployed in the lumen to occlude the primary entry tear.Immediate aortography was performed after procedure and the follow-up data of CT or MRI was evaluated.Results：Stent graft deployment was successfully performed.Immediate aortography after procedure showed no leakage in 36 patients and minor leakage in 2 patients.The diameters of thoracic and abdominal aortic true lumen increased significantly.Improvements of the blood flow in the distal aorta and abdominal branch-vessels were all achieved.No patients died during hospitalization and within 1 year after operation.Transient post-implantation syndrome occurred in 3 patients.Conclusion：Endovascular China-made stent graft is an efficient method.The operation is simple and safe with a high success rate,low complications and a good occlusion effect.