腔内覆膜支架修复术治疗Standford B型主动脉夹层49例临床分析

Clinical analysis of thoracic endovascular aortic repair in 49 cases of Standford B aortic dissection

目的：探讨腔内覆膜支架修复术（TEVAR）治疗 Standford B 型主动脉夹层的治疗效果。方法回顾性分析2010年1月至2015年12月58例 Standford B 型主动脉夹层患者，其中49例行 TEVAR，术前通过主动脉 CT血管成像（CTA）明确诊断并评估病情，通过腔内覆膜支架植入封堵原发破口治疗夹层。结果49例 TEVAR 术均成功，围术期无死亡病例，2例失访，随访率为95.9%，2例在术后半年内突发心脑血管意外死亡，其余患者均存活，复查 CTA 显示支架无移位和内漏，移植人工血管通畅。结论 TEVAR 是治疗 Standford B 型主动脉夹层的有效方法，创伤小，并发症少，安全性较高，治疗效果确切，短中期随访结果满意。

Objective To evaluate the clinical effect of thoracic endovascular aortic repair （TEVAR）on Standford B aortic dissection. Methods Retrospective analysis was made on the 58 cases of Standford B aortic dissection from January 2010 to December 2015,among whom 49 cases were treated by TEVAR. Before the operation,CTA was used for the diagnosis and evaluation of the disease,the stent grafts were used to isolate the primary crack of the throacic aortic dissection. Results The TEVAR treat-ment was successful in all of the 49 cases,no patient died during the perioperation period,47 cases were followed up（95. 9% ）. Two patients died after 6 months for cardio and cerebral vascular accident,and the rest patients survived without serious complication. Enhanced CTA scanning confirmed no endoleakage or translocation of stent grafts and the bypass grafts were unobstructed. Conclusions TEVAR is an effective method for treating Standford B aortic dissection,which is with minimal trauma,fewer complication,high security,exact therapeutic effect. The follow up results in short mid-term is satisfiing.