国产覆膜支架腔内隔绝术治疗Debakey Ⅲ型主动脉夹层20例

Endovascular graft exclusion in the treatment of Debakey Ⅲ type aortic dissection with domestic-made stent-graft in 20 Cases

目的探讨国产覆膜支架行腔内隔绝术治疗DebakeyⅢ型主动脉夹层瘤的手术适应症、临床疗效及并发症防治。方法 2009年1月—2012年1月,采用国产覆膜支架行腔内隔绝术治疗DebakeyⅢ型主动脉夹层20例。移植物经股动脉切口导入,至胸主动脉封闭夹层裂口,手术在全麻、数字减影血管造影(DSA)监视下完成。结果 20例患者支架置入定位准确,术后即刻造影显示真腔血流恢复正常。手术成功率100%,无术中转开胸手术,无截瘫及瘤体破裂等严重并发症,无围术期死亡。结论使用国产覆膜支架行腔内隔绝术治疗DebakeyⅢ型主动脉夹层具有创伤小,术后恢复快,手术死亡率低,手术成功率高的优点,但远期效果有待进一步观察。

Objective To investigate the operation indications, clinical therapeutic effects, and management of complication endovascular stent-graft exclusion in the DeBaKey Ⅲ type aortic dissection with domestic-made stent-graft. Methods EVGE was performed in 20 cases with Debakey Ⅲ type aortic dissecting aneurysm from Jan 2009 to Jan 2012. The self-expanded expanded polytetrafluo roethy lene-covered stents were placed to close entrytears in all patients through the delivery systems in troduced from the femoral arteries. All operations were performed under general anaes the sia and guidance of digital subtraction angiography. Results Stent-graft deployment was successfully performed, we could see that the blood current in the true lumen had been normal through aortography. The achievement ratio of operation was 100%. There were no severe proce- dure-related complications and accident-related to the dissection and surgery including paraplegia and angiorrhexis. There was no death in the ambi-operation time. Conclusion Endovascular stentgrafts deployment has many fortes in treating Debakey Ⅲ type aortic dissection, but further observation will be needed for evaluation of long-term results.