封堵器治疗Stanford B型主动脉夹层远端撕裂口的疗效观察

Therapeutic effect of occluders in the treatment of distal end tear of Stanford type B aortic dissection

目的 观察利用封堵器治疗Stanford B型夹层(TBAD)远端撕裂口的有效性及安全性.方法 对中山大学附属第一医院血管外科使用封堵器治疗TBAD患者远端撕裂口的4例病例进行经验总结,随访观察并发症发生情况及夹层假腔血栓形成情况.结果 4例手术均获得成功,术后1例少许内漏.4例患者均无封堵器移位及脱落.所有病例术后1周及3月CT血管造影复查假腔均基本血栓形成.3例随访4～5年未见夹层假腔扩大等并发症,1例死于脑出血.结论 采用封堵器治疗TBAD患者远端撕裂口疗效确切,安全可靠.

Objective To investigate the efficacy and safety of occluders in the treatment of distal tears of Stanford type B aortic dissection (TBAD).Methods The distal tears in 4 patients with TBAD were treated with occluders in our center.Complications and thrombosis in the false lumen of dissection were observed.Results The operation of 4 patients was successful.Endoleak was found in 1 case after operation.After 1 week and 3 months follow-up,computed tomography angiography confirmed thrombosis of the false lumen in all the cases.Three cases were followed up for 4 to 5 years,and were free of any complications including enlargement of the false lumen,while 1 case died of cerebral hemorrhage.Conclusion Management of distal tears of TBAD with occluders is effective and safe.