孤立性腹主动脉夹层的腔内治疗

Endovascular treatment for isolated abdominal aortic dissection

目的：总结孤立性腹主动脉夹层的临床特点和腔内治疗经验。方法：回顾性分析北京大学人民医院自2012年3月至2015年9月，收治的9例孤立性腹主动脉夹层患者病例资料，1例保守治疗，8例行腔内治疗。其中I型3例，行假腔栓塞治疗，II型5例，行腹主动脉覆膜支架腔内修复术治疗。结果：一期技术成功率100%，所有腔内治疗的患者夹层假腔均消失。术后患者腹痛症状消失，1例患者术后10个月发现假腔再次显影，再次行栓塞治疗后假腔消失。结论：孤立性腹主动脉夹层是一种临床少见但高危疾病，腔内治疗封闭夹层破口并闭合假腔，是治疗腹主动脉夹层的一种安全、有效的方法。

Objective： To evaluate the clinical feature and the endovascular treatment of isolated ab- dominal aortic dissection （IAAD）. Methods： From March 2012 to September 2015,9 IAAD patients had been treated in our department, one patient had got conservative treatment, 8 patients had got endovas＇cular treat- ment. Coil embolism therapy had been performed on 3 type I IAAD patients, and endovascular aortic repair （EVAR） therapy had been performed on 5 type II IAAD patients. Results：All endovascular procedures finally achieved technical success and all false lumens disappeared, abdominal pain remitted in all patients with this symptom. One patient was found the false lumen reappear 10 months after the initial endovascular treatment, coil embolism therapy had been performed again and the dissection healed. Conclusion：Isolated abdominal aor- tic dissection is a rare but serious and life-threatening disease, to close the tear and seal the false lumen of IAAD by endovascular treatments is a safe and effective option.