覆膜支架治疗37例Stanford B型胸主动脉夹层的疗效分析

Clinical analysis of 37 cases of Stanford type B thoracic aortic dissection treated with stent graft

目的:分析覆膜支架腔内修复治疗Stanford B型胸主动脉夹层的临床疗效。方法:对2015年1月至2016年12月收治的37例因Stanford B型胸主动脉夹层行覆膜支架腔内修复术患者的病历资料进行回顾性分析,其中男性29例,女性8例。术前诊断依据临床表现及CT血管造影(CTA),术中造影再次评估病变部位及解剖位置,切开股动脉,行覆膜内支架置入,封堵原发破口,手术成功后再次造影检查。结果:37例患者共置入支架37枚,全部获得成功。术中造影见少量内漏4例,3例经支架近端球囊扩张后内漏消失,1例无需特殊处理。患者临床症状均明显改善,降主动脉及腹主动脉真腔明显扩大。结论:采用覆膜支架腔内修复术治疗Stanford B型胸主动脉夹层安全、创伤小、恢复快,临床效果显著。

Objective：To investigate the clinical efficacy of stent graft in the treatment of Stanford type B aortic dissection. Methods：The clinical data of 37 cases of Stanford type B aortic dissection from January 2015 to December 2016 in our hospital were analyzed retrospectively.There were 29 males and8 females.The preoperative diagnosis was based on clinical manifestations,enhanced CT and CT angiography（CTA）.The lesion and anatomical location were evaluated again by angiography during the operation.The right or left femoral artery was cut,then followed by intravascular implantation of stent graft,blockage of primary breach and re-angiography after successful implantation. Results：The 37 patients were implanted with 37 stents.All of them underwent successful operation.Four cases were observed to have leakages by angiography during operation.Three of the leakages disappeared after the proximal balloon dilatation of the stent,while the last one did not need special treatment.The clinical symptoms of patients improved significantly.The descending and abdominal aortic true lumens were significantly expanded. Conclusions：The treatment of Stanford type B aortic dissection with stent graft repair has significantly clinical efficacy,which is safe,less traumatic and quick to recover.