Stanford B型主动脉夹层腔内修复术后血管重塑分析

Analysis of vascular remodeling of type B Stanford aortic dissection after endovascular stent-graft repair

目的 探讨Stanford B型主动脉夹层患者经胸主动脉腔内修复术（TEVAR）治疗后血管形态学转归。方法 回顾性分析51例接受TEVAR术治疗的Stanford B型主动脉夹层患者术前及术后临床及影像学资料,分析术后1个月内、1-6个月、6个月后主动脉各段真假腔内径及假腔血栓化情况。结果 TEVAR术后胸主动脉真腔扩大、假腔缩小,与术前比较差异有统计学意义（P〈0.05）,腹主动脉管径真腔和假腔变化较术前无统计学差异（P〉0.05）,腹部重要分支动脉血供情况较术前有所改善。结论 TEVAR术治疗Stanford B型主动脉夹层患者的近中期效果确切,但仍需要远期随访观察。

Objective To investigate the morphological changes of the aorta in patients with type B Stanford aortic dissection after transthoracic endovascular aortic repair （TEVAR）. Methods Both the preope- rative and postoperative clinical data and imaging materials of 51 patients with type B aortic dissection, who had received TEVAR, were retrospectively analyzed. The diameters of the true lumen and false lumen of each segment of aorta were measured within one month, 1-6 months and over 6 months after TEVAR, and the thrombosis in the thoracic aorta and abdominal aorta were assessed; the results were analyzed. Results After TEVAR, the true lumen of the thoracic aorta was enlarged while the false lumen of the thoracic aorta became narrowed, the differences were statistically significant （P〈0.05） when compared with the preoperative data. After the treatment the diameters of both the true lumen and the false lumen of the abdominal aorta showed no statistically significant changes when compared with the preoperative ones （P〉0.05）. The blood supply of the important abdominal aortic branches was improved if compared with the preoperative blood supply. Conclusion For the treatment of type B Stanford aortic dissection, TEVAR has definite short-term and medium-term effect, although the long-term result still needs to he clarified.