血管内覆膜支架置入治疗降主动脉夹层动脉瘤

Treatment of Descending Aortic Dissection with Stent-graft Placement

目的 :介绍血管内覆膜支架置入治疗降主动脉夹层动脉瘤的初步经验。材料与方法 :本组 6例 Debakey 型的慢性降主动脉夹层动脉瘤患者行血管内覆膜支架置入治疗。经股动脉将 Talent覆膜支架置于夹层动脉瘤裂口处 ,支架张开使覆膜支架固定于裂口附近的主动脉壁上将裂口封闭并阻断血流。结果 :6例病人均获得成功 ,手术和临床成功率 10 0 %。 1例患者术中出现内漏 ,置入第二枚支架后漏口封闭。平均随访 7个月 ,所有患者内膜裂口全部完全封闭 ,假腔内血栓形成无内漏 ,假腔均明显缩小。结论 :血管内覆膜支架置入治疗主动脉夹层动脉瘤具有安全可靠 。

Purpose To report preliminary experience with stent graft placement in the treatment of descending aortic dissection. Materials and Methods Six patients underwent endovascular stent graft placement for Debakey Ⅲ aortic dissection. All patients had chronic dissection. The stent graft was inserted over the site of intimal tear via femoral artery. The stent graft extended and anchored to the aortic wall, near the tear which was excluded from the blood flow. Results The procedure was technically and clinically successful in all patients. One case of endoleak occurred, second stent graft was inserted to seal the endoleak. In all patients ,closure of the entry tear and thrombosis of the false lumen along the stent graft were achieved. All false lumina shrank considerably. The mean follow up time was 7 months (range, 3 to 18 months ). Conclusion Descending aortic dissection can be treated safely and effectively by means of endovascular stent graft placement. Quick recovery after the operation is to be expected.