Stanford B型主动脉夹层腔内修复术前后内脏动脉供血形式的变化

The change of blood supply pattern in visceral arteries of Stanford B dissection after endovascular repair

目的 探讨腔内修复术对StanfordB型主动脉夹层腹腔动脉、肠系膜上动脉和肾动脉供血形式的影响。 方法 回顾性分析进行腔内修复术的 5 2例B型主动脉夹层患者的临床资料 ,通过主动脉血管造影观察夹层腔内修复术前后内脏动脉供血形式的改变。 结果 修复后内脏动脉供血改变 :完全真腔供血但狭窄的 7条血管中 ,6条修复后狭窄消失 ,1例修复后狭窄无变化 ;真假腔同时供血的 2 2条血管中 ,2 1条修复后完全恢复真腔供血或恢复真腔供血为主 ,1例供血形式无变化 ;完全假腔供血的 2条血管修复后 ,1条恢复真腔供血为主 ,1条供血形式无变化 ;无供血的 5条血管中 ,4条恢复真腔供血为主 ,1条无变化。 36条被破坏的内脏动脉中修复后真腔供血改善 88 9% ,真腔供血无变化 11 1% ,无真腔供血减少。 结论 腔内修复前被夹层破坏的内脏动脉供血形式以真假腔同时供血为主 ;腔内修复技术有利于被破坏内脏动脉恢复真腔供血。

Objective To discuss the change of blood supply pattern in visceral arteries of Stanford B dissection. The visceral arteries include celiac trunk(CA),superior mesenteric artery (SMA) and renal artery(RA). Methods By retrospectively analysing the clinical data of 52 cases with Stanford B dissection, the blood supply pattern of visceral arteries was confirmed by aortography and the changes before and after endovascular repair were compared. Results After repair: the stenosis lesions disappeared in 7 cases supported by true channel completely but one.Twenty-two visceral arteries supported by true and false channel simultaneously recovered true channel chiefly but one. One recovered true channel chiefly and one had no change in 2 visceral arteries supported by false channel completely.Four recovered true channel chiefly and one had no change in 5 visceral arteries without blood support.88.9% blood support got better and 11.1% blood support had no change in 36 damaged visceral arteries after endovascular repair. Conclusion Blood support from true and false channel simultaneously is the chief pattern in the injured visceral arteries before repair; Endovascular repair technique is benefit to recovering the blood support of true channel.