应用带膜支架腔内置入术治疗主动脉夹层的初步经验

Experience of Endoluminal Stent Graft Implantation for Aortic Dissection

目的 :介绍应用带膜支架腔内置入术治疗主动脉夹层的初步经验。方法 :在全麻、数字减影动脉造影术 (DSA)监控下 ,切开股动脉 ,将带膜支架置入降主动脉内膜破口处 ,将破口封闭。采用国产带膜支架腔内置入治疗 7例主动脉夹层患者 ,DeBakeyⅢa型 2例、Ⅲb型 4例 ,Ⅰ型 1例。 7例中 60岁以上 5例 ,其中 70岁以上 2例 ,有 6例伴随其他脏器疾病。结果 :所有患者带膜支架置入后破口完全封闭 ,真腔血流恢复正常 ,技术成功率 10 0 %。无中转开胸手术 ,无截瘫、瘤体破裂等严重并发症 ,无围术期死亡。随访 1～ 12个月 ,1例 2个月后腹主动脉内膜破口再置一个带膜支架 ,余 6例均经螺旋计算机断层摄影术证实无内漏及支架移位等并发症发生。结论 :带膜支架腔内置入治疗主动脉夹层具有技术可靠、创伤小、术后恢复快、成功率高等优点 。

Objective:To describe the primary experience of endoluminal stent graft implantation for aortic dissecting aneurysm Methods:Seven cases were supervised under digital subtraction arteriography (DSA) and implanted endoluminal stent graft to close the rupture of descending aorta And all aortic Chinese endoluminal stent grafts were implanted in all aortic dissections,DebakeyⅢa in 2,DebakeyⅢb in 4,Debakey I in 1 Five patients were>60 and two>70 years old Six patients had other concurrent diseases Results:On Helix computed tomography (CT) scans and angiography,all ruptures were completely closed and the blood flow returned to normal in the true luma There was no death or serious complications at perioperation. A follow up of 1 12 months was carried out All were successful except one which had a second stent because of abdomenal aortic rupture Conclusion:Endoluminal stent graft for aortic dissection is available and reliable,especially for patients at high risk of operation