带膜支架腔内植入升主动脉治愈全主动脉夹层

Endovascular stent-graft deployed in ascending aorta for the treatment of total aortic dissection.

目的 开展带膜支架腔内植入升主动脉治疗DeBakeyⅠ型主动脉夹层的临床研究。 方法 报告采用带膜支架腔内植入治愈DeBakeyⅠ型主动脉夹层 1例。 结果 从左颈总动脉送入导丝和带膜支架至升主动脉封闭撕裂口。此前先建立左锁骨下动脉至左颈总动脉的内转流通道。二枚带膜支架重叠放置成功封闭升主动脉撕裂口 ,术后复查彩超示胸腹主动脉夹层消失 ,假腔内血栓形成 ,病人痊愈出院。结论 带膜支架腔内植入是治疗DeBakeyⅠ型主动脉夹层的有效方法。通过颈总动脉送入支架和预先建立颈总动脉内转流通道可保证手术的成功进行。

Objective To develop and study endovascular stent-graft deployed in ascending aorta for the treatment of the clinical cases with DeBakey Ⅰ aortic dissection. Methods We reported the successful application of endovascular stent-graft deployment in ascending aorta for the treatment of one case with DeBakey Ⅰ aortic dissection. Results Closing of the entry site was facilitated with a guidewire and ployster-covered stent-grafts exited into the ascending aorta through left common carotid artery,before that,internal shunt from left subclavian artery to left common carotid artery was established.Two polyster-covered stent-grafts were successfully placed in the ascending aorta to close the entry site.Disappearing of aortic dissection and thrombosis in the false lumen were demonstrated by color doppler ultrasonography after operation.The patient recovered and was discharged. Conclusion Endovascular stent-graft deployment is the effective method of treating DeBakey Ⅰ aortic dissection.Transportation of stent-graft through common carotid artery and internal shunt establishment of common carotid artery may ensure the successful performance of the procedure.