主动脉弓曲率对主动脉夹层手术方式的影响

Effect of aortic arch curvature on surgery of aortic dissection

目的探讨主动脉弓曲率对主动脉夹层术式的影响。方法对东莞康华医院2009年1月至2018年3月施行的主动脉夹层腔内隔绝术32例患者的资料进行回顾性分析。覆膜支架释放成功后进行主动脉数字减影血管造影(DSA),术后行螺旋三维计算机断层扫描(CT),分别评估有无内漏及内漏的大小,决定内漏的处理。术后随访3～36个月。分析不同主动脉弓曲率对术式的影响。结果主动脉弓曲率大组与主动脉弓曲率小组之间内漏患者比例及术式比较,差异有统计学意义(P<0.05)。结论主动脉弓曲率过大可以引起主动脉支架的前跳、后跳移位及内漏等各种不良事件的产生。

Objectives To investigate the effect of aortic arch curvature on surgery of aortic dissection. Methods Clinical characteristics of 32 cases with endovascular aortic dissection in Dongguan Kanghua Hospital from January 2009 to March 2018 were retrospectively analyzed. Digital subtraction angiography (DSA) of aorta and spiral three-dimensional computed tomography (CT) were performed after the stent was released successfully. Whether there was aleak and the size of leak were assessed respectively by DSA and CT to determine the treatment of leak. The follow-upperiod was 3-36 months. Effect of different aortic arch curvature on the surgical procedure was analyzed. Results Significantdifferences of percentage of patients with leak and surgical procedure were found between large aortic arch curvaturegroup and small aortic arch curvature group. Conclusions Excessive aortic arch curvature can cause various adverseevents such as anterior jump,posterior jump and internal leak of aortic stent.