远端破口存在对于Stanford B型夹层腔内修复术后早中期疗效的影响

The Effect of the Presence of a Distal Incision on the Early- and Mid-Stage Outcome after Stanford Type B Endovascular Therapy

目的:Stanford B型夹层行腔内修复术后远端破口的存在对于术后早中期疗效及主动脉重塑情况的分析。方法:回顾性研究安徽医科大学第二附属医院2014年1月至2019年11月CTA结果提示Stanford B型夹层并行腔内修复术的患者,总计47例,按术后远端单一破口及多破口分为A、B两组。分析两组患者间术后早中期内漏、远端破口愈后、主动脉重塑的差异性及内漏形成的因素。结果:随访术后3、6和9个月主动脉CTA,B组较A组更易发生内漏,P 【0.05。腔内修复术时夹层处于急性期或第一破口位于小弯侧者,随访期间更易发生内漏(P 【0.05)。两组患者远端破口早中期愈后无统计学差异。术后支架覆盖段胸主动脉段恢复A组较B组更佳(P 【0.05)。对于整体患者而言,支架未覆盖段腹主动脉段重塑均较差,但A组较B组稍好(P 【0.05)。结论:Stanford B型夹层患者腔内修复术后远端多破口早中期疗效及主动脉重塑较单破口者差,支架覆盖段主动脉重塑情况两组均较好,腔内修复术治疗Stanford B型夹层疗效让人满意。

Objective: To analyze the presence of distal incision after Stanford Type B endovascular therapy for early and middle postoperative efficacy and aortic remodeling. Methods: A retrospective study was conducted on 47 patients with Stanford Type B endovascular therapy in the Second Hospital of Anhui Medical University from January 2014 to November 2019. The patients were divided into Group A and Group B with single and multiple distal lacerations. The differences of postoperative early and middle period leakage, distal incision recovery, remodeling of aorta and the factors of postoperative leakage were analyzed. Results: Group B is more likely to have postoperative leakage than Group A (P