西宁地区腔内隔绝术治疗Stanford B型主动脉夹层动脉瘤45例分析

Analysis of 45 Cases of Stanford B Aortic Dissection Aneurysm after Endovascular Graft Exclusion in Xining Area

目的:评价西宁地区腔内隔绝术治疗Stanford B型主动脉夹层的疗效和安全性。方法:收集2004年5月—2012年5月青海省心脑血管病专科医院主动脉腔内覆膜支架隔绝术治疗45例Stanford B型主动脉夹层动脉瘤资料。经股动脉切开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。结果:腔内隔绝术成功率100%,共置入45枚主体覆膜支架及2枚Cuff支架,2例患者完全封闭左锁骨下动脉开口,无左上肢及脑供血不足症状。本组共死亡3例,其中与腔内隔绝术有关死亡1例,发生在术后5天,与腔内隔绝术无关死亡2例,1例为自发性气胸,1例为急性心肌梗死。结论:西宁地区腔内隔绝术治疗Stanford B型主动脉夹层近、中期疗效好,并发症低。

Objective：To assess the efficacy and safety of therapy of Stanford B aortic dissection aneurysm （ADA） after endovascular graft exclusion. Methods：g5 cases of Stanford B ADA, who underwent endovascular graft exclusion, were collected from May 2004 to May 2012 in our hospital. The plugging of thoracic aortic rupture was conformed by placing stent - graft through the femoral arteriotomy. The efficacy of treatment was assessed by angiography. Results：Success rate of endovaseular graft exclusion was 100% in 45 main stent and 2 cases of cuff bracket. 1 of 3 dead cases related to this endovascular graft exclusion, others died of spontaneous pneumothorax and acute myocardial infarction respectively. Conclnsions：The endovascular graft exclusion is an effective method for treatment of Stanford B ADA, and lower complications during short and medium term of operation in Xining area.