DeBakeyⅢ型主动脉夹层腔内隔绝术后近端Ⅰ型内漏的影响因素分析

Factors of proximal type I endoleak after thoracic endovascular aortic repair in patients with De Bakey type Ⅲ aortic dissection

目的 探讨DeBakeyⅢ型主动脉夹层患者行主动脉腔内隔绝术（thoracic endovascular aortic repair,TEVAR）后近端Ⅰ型内漏的影响因素.方法 对东莞康华医院2009年6月至2014年7月期间83例行TEVAR术的DeBakeyⅢ型主动脉夹层患者的临床资料进行回顾性分析.术中及术后分别采用主动脉数字减影血管造影（DSA）以及螺旋三维计算机断层扫描对内漏进行评估.术后随访时间为2-63个月.结果 83例患者中出现近端Ⅰ型内漏10例,术中出现内漏者6例,迟发性Ⅰ型内漏4例.结论 Ⅰ型内漏是TEVAR术的常见并发症,血管因素、移植物的选择以及术者的经验均可影响内漏的发生.

Objectives To investigate the influence factors of proximal type Ⅰ endoleak after thoracic endovascular aortic repair （TEVAR） in patients with DeBakey type Ⅲ aortic dissection.Methods Clinical data of 83 patients received TEVAR surgery for DeBakey type Ⅲ aortic dissection from June 2009 to July 2014 in Dongguan Kanghua Hospital were retrospectively analyzed.Endoleak was assessed by aortic digital subtraction angiography （DSA） and three-dimensional spiral computed tomography （CT）,during and after operation.Follow-up duration was 2-63 months.Results Proximal type Ⅰ endoleak occurred in 10 patients,of which,6 cases were found type Ⅰ endoleak during the operation,4 cases were found delayed type Ⅰ endoleak.Conclusions Type Ⅰ endoleak is a common complication of TEVAR,which can be affected by vascular factors,graft selection and operator experience.