带膜支架植入治疗B型主动脉夹层35例临床分析

Clinical analysis of 35 patients with type B aortic dissection treated with stent implantation

目的:探讨带膜支架植入治疗B型主动脉夹层的临床疗效。方法:收治B型主动脉夹层患者35例,均行带膜支架植入治疗,观察临床治疗效果及并发症发生情况,出院后定期影像学复查患者恢复情况。结果:35例患者手术成功率100%,隔绝术后行DSA复查,其中原发破口完全封闭32例,出现近端内漏3例,经球囊扩张后,内漏减少。术后随访,失访1例,随访34例,其中发生Ⅰ型内漏5例,内漏量大行短支架(Cuff)植入治疗2例,少量内漏在随访中自行消失3例;随访中近端假腔消失11例(31.4%),假腔血栓形成25例(71.4%),夹层远端假腔仍有血流17例(48.6%)。结论:带膜支架植入治疗B型主动脉夹层术后恢复快、并发症少、中长期疗效稳定。

Objective:To investigate the clinical effect of type B aortic dissection treated with stent implantation.Methods:35 patients with type B aortic dissection were selected.They were all treated by stent implantation.We observed the clinical treatment effect and complications,after discharge,regular radiographic reviewed the patients' recovery.Results:The success rate of 35 cases was 100% .After isolation of postoperative DSA review,32 cases closed the primary break completely,and there were 3 cases of proximal internal leakage.After balloon dilatation,the leakage was reduced.Postoperative follow-up,1 case was lost,followed up in 34 cases,including 5 cases of patients with type I endoleak,the amount of leakage in 2 cases for short stent(Cuff)implantation,3 cases of small endoleak during follow-up disappeared,11 cases of proximal false lumen disappeared(31.4% ),false lumen thrombosis in 25 cases(71.4%), still blood flow in the distal false lumen in 17 cases(48.6%).Conclusion:Stent implantation in the treatment of type B aortic dissection had rapid postoperative recovery,low complications,long-term effect and stability.