股动脉穿刺缝合技术在B型主动脉夹层介入治疗中的应用

Percutaneous femoral artery access for TEVAR of type B aortic dissection

目的探讨股动脉穿刺、缝合技术在B型主动脉夹层介入治疗过程中的安全性及有效性。方法回顾性分析2012年1月-2016年12月中国人民解放军海军总医院心内科行介入治疗的B型主动脉夹层患者的资料，按照建立手术入路方式的不同，分为切开暴露股动脉组及穿刺股动脉联合缝合组。分析2组间的安全性及有效性。结果共32例患者入选，其中股动脉切开组20例，穿刺缝合组12例，患者均顺利完成手术，2组在性别、年龄及体重指数方面均差异无统计学意义。与切开暴露股动脉组相比，穿刺股动脉联合缝合组手术时间明显缩短，入路相关并发症无明显差异。结论在B型主动脉夹层介入治疗过程中，采用股动脉穿刺缝合技术是一种微创、安全、有效的方法，值得临床推广。

Objective The retrospective study was designed to assess the safety and effectiveness of percutaneous femoral artery access for thoracic endovascular aortic repair （TEVAR） of type B aortic dissection. Methods Retrospectively analysis the clinical database of our hospital between January 2012 to December 2016, the total of 32 patients, that were undergone TEVAR because of type B aortic dissection, were included. According to the approach of building vascular access, they were divided into open femoral-exposure access group and percutaneous femoral access group, and then analysis the safety and effectiveness in both two groups. Result Open femoral-exposure access group has 20 cases, and percutaneous femoral access group has 12 cases. The procedures were successfully completed among total of 32 cases. There are no significantly difference between both groups in gender, age, BMI and access-oriented complication. Compared with the open femoral-exposure access group, percutaneous femoral access group has a shorter operative time. Conclusion During tile procedure of TEVAR for type B aortic dissection, using percutaneous femoral access with an adjunctive pre-close technique is safe and effective, with minimally and is worthy of clinical promotion.