联合远端限制性支架腔内修复治疗Stanford B型主动脉夹层

Combination of distal restrictive stent for treatment of Stanford type B aortic dissection

目的：探讨联合远端限制性支架腔内修复治疗Stanford B型主动脉夹层的近期疗效.方法：回顾性分析2012年5月至2013年4月间,新疆医科大学第一附属医院,采用联合限制性支架治疗28例Stanford B型主动脉夹层患者的临床资料,分析远端限制性支架在stanford B型主动脉夹层主动脉腔内修复术（endovascular aortic repair,EVAR）术中的疗效.结果：远端限制性支架治疗Stanford B型主动脉夹层28例,其中男性25例,女性3例.年龄30～73岁,平均（49.80±12.71）岁.急性期治疗22例（均为急性复杂性夹层）,慢性期治疗6例.主体支架直径为30～36 mm,长度150 ～ 200 mm；限制性支架直径为24 ～ 28 mm,长度为60～ 80 mm,其中覆膜支架23例,大口径裸支架5例.技术成功率100％,术后即刻观察Ⅰ型内漏3例,无截瘫发生.术后随访3～ 14个月,平均7个月,3例有明确Ⅰ型内漏的患者,术后3个月随访主动脉CTA检查显示内漏消失,1例患者术后第11个月发现肾衰竭,5例患者左侧肢体发凉,2例患者头晕,无脑卒中、截瘫及死亡.结论：联合限制性支架治疗Stanford B型主动脉夹层术较传统腔内修复术近期疗效较好,远期疗效有待于进一步观察.

Objective：To evaluate the early outcomes of the distal restrictive stent in endovascular re- pair （EVAR）of Stanford type B aortic dissection. Methods：The clinical data of 28 patients with Stanford type B aortic dissection in our hospital from May 2012 to April 2013 were analysed retrospectively. Results ：There were 28 cases who accepted distal restrictive stent in endovascular repair of Stanford type B aortic dissection. The mean age was 49. 8 years. The rate of procedure success was 100%, 3 cases had endoleak of type I, and no paraplegia in postoperative. The mean follow up period was 9 months, during which lease with chronic renal failure, 5 cases with left limb cold, 2 cases with dizziness, and no stroke, no paraplegia, no late death oc- curred. Conclusion： Early results showed that distal restrictive stent repair was effective in treatment of type B aortic dissection.