主动脉弓部病变的腔内治疗

Clinical effect of endovascular treatment for aortic arch disease

目的:总结22例主动脉弓部病变腔内治疗的临床经验。方法:22例患者经主动脉血管造影确诊,在全身麻醉或局部麻醉下接受腔内治疗。其中17例Stanford B型夹层,1例Stanford A型夹层,4例主动脉弓部动脉瘤。结果:技术成功率100%,术后逆行剥离成Stanford A型夹层1例,脑梗死1例,肾功能不全2例,肺部感染3例;血红蛋白和血小板降低8例。结论:对有选择的主动脉弓部病变患者,腔内治疗是安全的;完全腔内修复和杂交手术作为腔内治疗的两种手段,扩大了腔内治疗的适应证,降低了并发症的发生和病死率。

Objective：To summarize the clinical effect of endovascular treatment for 22 cases with aortic arch diseases. Method： Twenty two patients including Stanford type B dissection （17 cases）, Stanford type A dissection （1 case） and aortic arch aneurysm （4 cases） were diagnosed by aortic angiography. All cases received endovascular treatment under general or local anesthesia. Result： All endovascular procedures were technically successful. One patient suffered from Stanford type A dissection due to retrograde dissection after operation. Other complications included cerebral infarction （1 case）, renal insufficience （2 cases）, pneumonia （3 cases）, anemia and low blood platelet （8 cases）. Conclusion： Endovaseular treatment is safe and effective for the selective patients with aortic arch diseases. Endovascular repair and hybrid procedure expand the indications of endoluminal treatment, and decrease the incidence of complication and mortality rate of aortic dissection.