DeBakey Ⅲ型主动脉夹层的介入治疗

Interventional therapy of DeBakey Ⅲ aortic dissection

目的 探讨多种介入方法对DeBakeyⅢ型主动脉夹层的临床疗效。 方法 DeBakeyⅢ型主动脉夹层 10例 ,9例行腔内隔绝术 ,1例行内膜瓣开窗术及内支架置入术。结果 9例腔内隔绝术均获成功 ,出现I型内漏 3例 ,经球囊扩张后 ,2例内漏消失 ,1例仍有内漏。 1例术后 3天猝死。 1例行内膜瓣开窗术及内支架置入术获得成功 ,远端脏器供血正常。结论 综合性介入治疗对于DeBakeyⅢ型主动脉夹层具有良好的近、中期疗效 。

Objective To study the clinical effect of comprehensive interventional therapy for DeBakey Ⅲ aortic dissection. Methods Ten patients with DeBakey Ⅲ aortic dissection was treated with interventional therapy, including endovascular exclusion (EVE) (9 patients), fenestration of intimal flap (FIF) and endovascular stent placement (ESP) (1 patient). Results EVE was successfully finished in 9 cases. Type I endoleakage was found in 3 patients, disappeared after PTA in 2 patients, still presenting in one patient. One patient suffered sudden death 3 days after operation. FIF and ESP were successful and ischemic symptoms of distal visceral organ disappeared. Conclusion Although the long term results are not available, early and midterm effect of comprehensive interventional therapy for DeBakey Ⅲ aortic dissection is satisfactory in our study.