腔内隔绝术治疗主动脉夹层Stanford B型的近期和中期疗效

Endovascular graft exclusion in patients with aortic dissection stanford type B: early and mid-term results

目的:分析腔内隔绝术治疗主动脉夹层Stanford B型的近、中期疗效。方法:回顾性分析2007-05-2012-04期间我院87例腔内隔绝术治疗Stanford B型主动脉夹层患者的临床资料,所有患者均经皮股动脉穿刺建立股动脉入路完成主动脉腔内隔绝术。结果:手术成功率96.5%(84/87),平均住院时间(6±2)d,平均手术时间(115±35)min[其中建立入路时间(6±2)min,术毕入路处理时间(4±2)min],术后住CCU(13±5)h,术后住院时间(3±1)d,平均对比剂用量(135±34)ml;整体并发症发生率17.2%(15/87),主要并发症发生率3.4%(3/87),次要并发症发生率13.8%(12/87),院内病死率2.2%(2/87)。随访截至2012年5月,所有患者平均随访时间(42±17)(1～60)个月,随访率96.6%;30d、1年、2年、3年及4年生存率分别为97.7%、95.2%、90.5%、87.0%及85.7%;假腔血栓形成93.1%(81/87);整体并发症发生率11.9%(10/84),与腔内隔绝术相关随访病死率2.4%。结论:腔内隔绝术治疗主动脉夹层Stanford B型具有良好的近期和中期效果。

Objective：To analysis the efficacy of endovascular graft exclusion （EVGE） in patients with aortic dissection type B. Method： From May 2007 to April 2012, endovascular treatment of 87 cases in our hospital aortic dissection Stanford type B： a clinical retrospective analysis of data. All patients with percutaneous femoral artery puncture and establishment of femoral arteries in endovascular graft exclusion for aortic road completed. Result： In- hospital data： surgery success rate 96.5% （84/87）, average hospital time （6±2）d, average surgery time （115± 35）rain, which established into road time （6±2）min, operation completed into road processing time （4±2）min, postoperative CCU （13± 5） h, postoperative hospital time （3 ± 1 ） d, average comparison agent dosage （ 135 ± 34 ） ml. Overall complication rate 17.2%, major morbidity 3.4%, minor complication rate 13.8%, hospital mortality rates 2. 2 %. Follow up data after st ent-graft ： as of May 2011, all patient follow up time of （42 ± 17） months, range （1 -60） months, and follow up 96.6%. Thirty days, 1 year, 2 year, 3 year, and 4 year survival rates were 97.7%, 95.2%, 90.5%, 87.0%, and 85.7%, respectively. Vena thrombosis was 93.1% （81/87）. Overall complication rate was 11.9%, and related follow-up endovascular CFR was 2.4%. Conclusion： Endovascular treatments of aortic dissection Stanford type B have good short and medium-term effects.