分期TEVAR手术封堵DeBakey Ⅲ型主动脉夹层远端破口并重建腹主动脉内脏分支的临床研究

Clinical Study of Staged TEVAR Operation to Occlude the Distal Rupture of DeBakeyⅢAortic Dissection and Reconstruce the Visceral Branches of Abdominal Aorta

目的 研究分期TEVAR手术封堵DeBakey III型主动脉夹层远端破口并重建腹主动脉内脏分支临床疗效。方法 回顾性分析我科2019年4月至2021年1月,分期TEVAR手术隔绝DeBakey III型主动脉夹层并重建腹主动脉内脏分支10例。结果 10例患者均取得成功,技术成功率100%。术中、术后影像学证实主动脉夹层近远端破口隔绝良好、无内瘘、无内脏分支狭窄/闭塞、术中无中转、死亡病例,术后无死亡、脑梗死、心肌梗死、截瘫、脏器缺血等严重并发症。结论 分期TEVAR手术隔绝DeBakey III型主动脉全段夹层破口并重建内脏分支技术可行、安全性高,具有较高的临床价值。

Objective To study clinical effet of staged endovascular repair of thoracic aorta(TEVAR)operation to block the distal break of DeBakey III aortic dissection and reconstruct the visceral branch of abdominal aorta.Methods From April 2019 to January 2021,10 cases of DeBakey III aortic dissection were isolated and abdominal aortic visceral branches were reconstructed by staged TEVAR surgery in our department.Results Intraoperative and postoperative imaging confirmed that proximal and distal breaks of aortic dissection were well isolated,no internal fistula,no visceral branch stenosis/occlusion,no transit and death cases during the operation,and no serious complications such as death,cerebral infarction,myocardial infarction,paraplegia and organ ischemia after the operation.Conclusion Staged TEVAR would be a feasible and safe technique for isolating DeBakey type III aortic dissection and reconstructing visceral branches,which would have high clinical value.