TEVAR术后支架远端主动脉夹层先兆破裂经再次TEVAR术救治1例并文献分析

One case with threatened rupture of distal aortic dissection after TEVAR treated by TEVAR one more and literature analysis

Standford B型主动脉夹层病情凶险,死亡率高,一经确诊需要立即手术,胸主动脉腔内修复术(TEVAR)是Standford B型主动脉夹层首选治疗方案,但术后支架远端破裂已经成为TEVAR术不可忽视的并发症,对此并发症处理十分重要。笔者分析2018年5月24日四川省遂宁市中心医院收治的1例TEVAR术后支架远端主动脉夹层先兆破裂经再次TEVAR术救治患者的临床资料,发现TEVAR术后发生支架远端破入胸腔,经再次行TEVAR术,并辅以纠正休克、纠正低蛋白血症、胸腔穿刺引流为主等综合治疗,术后恢复良好,同时未出现严重并发症,提示TEVAR术治疗Standford B主动脉夹层为有效治疗方案。

Standford type B aortic dissection is dangerous and has a high mortality rate.Once this disease is diagnosed,immediate surgery is needed.Thoracic endovascular aortic repair(TEVAR)is the first treatment for Standford type B aortic dissection,but distal stent rupture has become a complication of TEVAR,which is very important to deal with.The author analyzes the clinical data of one patient with rupture of distal aortic dissection after TEVAR treated by TEVAR one more on May 24,2018 in Suining Central Hospital of Sichuan Province.It was found that the distal stent ruptured into thoracic cavity after TEVAR,then the patients were treated by TEVAR again and assisted by shock correction,hypoproteinemia correction,thoracic drainage and thoracentesis as the main comprehensive treatment,the postoperative recovery is good,with no serious complications.It is suggested that TEVAR is an effective treatment for Standford B aortic dissection.