烟囱技术治疗主动脉弓部分支血管受累Stanford B型主动脉夹层23例临床分析

Using the chimney technology treatment of aortic arch part vascular involvement Stanford type B aortic dissection of 23 cases of clinical analysis

目的 探讨烟囱技术治疗主动脉弓部分支血管受累Stanford B型主动脉夹层的临床效果.方法 对我院2013年9月至2016年10月治疗的23例主动脉弓部分支血管受累的Stanford B型主动脉夹层患者的临床资料、手术方法、随访结果行回顾性分析.结果 23例患者中1例烟囱支架闭塞,1例术后死亡,1例逆剥形成A型夹层,5例术后Ⅰ型内漏;无脊髓缺血导致截瘫,无远端支架贴附不良,无支架远端相关并发症,无支架移位,无脑梗及脏器缺血等并发症.结论 对于主动脉弓分支血管受累的Stanford B型主动脉夹层采用烟囱技术扩大了腔内治疗的适应证,提高手术成功率,将复杂的手术简单化,获得了满意的临床疗效.

Objective To investigate the chimney technology treatment of aortic arch part of vascular involvement Stanford type B aortic dissection of the clinical effect and provide reference for clinical treatment.Methods In our hospital between September 2013 and October 2016 to treat aortic arch part of the vascular in-volvement of Stanford type B aortic dissection method the clinical data of 23 cases,surgery and follow-up results were retrospectively analyzed.Results 23 cases 1 example chimney stent occlusion;1 case of postoperative death;type A dissection 1 case agnail formation;5 cases of postoperative leakage inside Ⅰ type;Without spinal cord ischemia result in paraplegia,distal stent attached with a bad,no stent distal related complications,no stent displacement,no complications such as ischemic cerebral infarction and organs.Conclusion For the branch of the aorta vascular involvement of Stanford type B aortic dissection by chimney technology enlarged the intracavitary treatment indications,this simplified operation improve the success rate of surgery and obtain satisfactory clinical effect,the patients benefit from this effective treatments.