B型主动脉夹层介入治疗部分封堵左锁骨下动脉的影响探讨

Influence of interventional therapy of partially blocking left subclavian artery on B-type aortic dissection

目的观察B型主动脉夹层患者通过腔内修复手术中部分封堵左锁骨下动脉后的疗效。方法选择自2009年1月~2016年1月于汉中市人民医院接诊的35例通过部分封堵左锁骨下动脉治疗B型主动脉夹层患者的临床及术后半年随访资料进行回顾性分析,评估手术相关的并发症发生情况。结果 35例患者中有34例植入覆膜支架取得成功,未成功患者是主动脉迂曲导致,手术用时(53.8±5.4)min,住院时间为(6.0±1.7)d;对患者进行半年的随访,结果显示出,34例部分封堵左锁骨下动脉的患者中,3例出现左上肢缺血症,1例产生一过性眩晕及脑缺血发作,其他患者在术后随访中并未发生任何不良症状。结论在B型主动脉夹层患者中应用部分封堵左锁骨下动脉技术操作简单便捷,在B型主动脉夹层的治疗方式中已成为首选,但还需根据Willis环及左椎动脉情况做适当选择。

Objective To observe the curative effect of partial blocking of left subclavian artery through endovascular repair in patients with B-type aortic dissection. Methods The patients undergone partial blocking of left subclavian artery（n=35） were chosen from the People＇s Hospital of Hanzhong City from Jan. 2009 to Jan. 2016, and their clinical data and follow-up material after half year were retrospectively analyzed. The incidence of complications related to the operation was reviewed. Results Of 35 patients, there were 34 with success implantation of covered stents, and only one with unsuccessful operation due to aortic circuity. The operation time was（53.8±5.4） min, and hospital stay time was（6.0±1.7） d. The results of follow-up for half year showed that among 34 patients undergone partial blocking of left subclavian artery, 3 had ischemia of left upper limb and 1 had transitional dizziness and transient ischemic attack, and other patients had no any adverse symptoms. ConclusionThe technique of partial blocking of left subclavian artery is easy and quick, which is the first choice for treating B-type aortic dissection. It should be, however, on the basis of status of Willis ring and left vertebral artery.