主动脉腔内支架修复术治疗急性创伤性主动脉夹层

Endovascular aortic repairment in treatment of acute traumatic aortic dissection

目的探讨主动脉腔内支架修复术治疗急性创伤性主动脉夹层(TAD)的治疗策略及疗效。方法回顾性分析2016年7月至2017年12月我院收治的8例急性创伤性主动脉夹层患者的临床资料。所有患者均行胸腹主动脉计算机体层摄影血管造影(CTA)明确诊断为Stanford B型,采用主动脉腔内支架修复术(EVAR)治疗。收集并分析各患者术前临床特点、术中手术资料、术后随访结果。结果手术时间(61. 2±25. 6) min,住院时间(12. 7±6. 3) d;围手术期无死亡病例,术后无左侧锁骨下动脉盗血、截瘫、肝肾功能衰竭及脑梗死等并发症。出院后随访3～23个月,平均(13. 2±9. 8)个月,复查CTA均显示破口封闭良好,支架无内漏、移位。结论与传统体外循环下人工血管置换相比,EVAR手术具有微创、便捷、安全有效等特点,是治疗急性创伤性主动脉夹层安全有效的方法。

Objective To explore the treatment strategy and efficacy of edovascular aortic repairment for acute traumatic aortic dissection. Methods Endovascular aortic repairment were performed on 8 patients of acute traumatic aortic dissection from July 2016 to December2017 after diagnosed by aortic computed tomography angiography( CTA). Preoperatie clinical characteristics,intraoperative surgical data and postoperative follow-up results were collected and analyzed. Results The average operation time was( 61. 2 ± 25. 6) minutes;and the average length of hospital stay was( 12. 7 ± 6. 3) days. All the patients survived,and there was no complication( such as subclavian steal syndrome,paraplegia,liver and kidney failure,cerebral infarction) occured. The patients were followed up for 3 to 23 months,with an average of( 13. 2 ± 9. 8) months. Reexamination of CTA showed that there was no stent inner leakage and displacement. Conclusion Compared with the traditional extracorporeal circulation artificial blood vessel replacement,endovascular aortic repairment is an effective method for acute traumatic aortic dissection,which is minimally invasive,convenient and safe.