经皮内膜瓣开窗术及内支架置入术治疗主动脉夹层(附一例报告及文献复习)

Percutaneous fenestration of intimal flap and endovascular stent placement for aortic dissection: 1 case report and reference review

目的 探讨经皮主动脉夹层内膜瓣开窗术 (FIF)及内支架 (ES)置入术治疗主动脉夹层的临床应用价值。方法 男 ,5 4岁 ,DeBakeyⅢb型主动脉夹层 ,内膜瓣破裂口位于降主动脉 ,腹主动脉及右髂动脉真腔变窄 ,最窄处内径仅为 3mm。经股动脉行主动脉夹层FIF及ES置入术 ,共置入ES4枚。结果 腹主动脉真腔及其各分支血流基本得到恢复。初步观察最狭窄处内径增至 12 3mm ,病人症状完全消失。结论 经皮主动脉夹层FIF及ES置入术治疗主动脉夹层具有损伤性小 ,并发症少 ,疗效显著等特点。因此 ,可作为治疗某些主动脉夹层的安全有效的首选方法。

Objective To evaluate the safety and effect of percutaneous fenestration of intimal flap(FIF) and endovascular stent(ES) placement for aortic dissection. Methods Male patient, 54 years old. DeBakey Ⅲb aortic dissection, tear of intimal flap situated at the beginning of desconding aorta, developed to abdominal aorta and right iliac artery. The true lumen was 3 mm at narrowest locatation. Through femoral artery approach, percutaneous fenestration of intimal flap and ES placement are operated and four ES were placed. Results The blood flow of aortic true lumen and branches were resumed. The true lumen raised to 12 3 mm at the narrowest locatation. The clinical symptoms vanished. Conclusion Percutaneous fenestration and ES placement for aortic dissection feature little injure, high safety and effecacy. So, It is the first choice for certain aortic dissection.