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目的评价覆膜支架治疗Stanford B型主动脉夹层(AD)的疗效。方法 2004年1月～2010年12月对36例Stanford B型AD患者行覆膜支架治疗,在患者出院后1个月、半年、1年时进行电话随访并定期复查CT血管造影(CTA),以后每年随访一次,对其治疗效果及其并发症进行临床分析。结果手术成功率100%。术后4例(11.1%)患者出现I型内漏,放置球囊后内漏均消失;1例出现神经系统症状;无术后截瘫、下肢缺血症状。住院期间无死亡病例。34例(94.4%)患者获得随访;平均随访时间(25.7±25.1)个月,定期复查CTA,假腔无明显增大,内有血栓形成。随访期间死亡4例(11.8%)。结论覆膜支架治疗Stanford B型AD疗效确切,能明显降低住院期间症状和死亡率,远期疗效有待进一步观察。
Objective To evaluate the efficacy of stent-graft in the treatment of Stanford type B aortic dissection (AD). Methods Thirty - six patients with Stanford type B AD were treated with stent - graft from January 2004 to December 2010. The patients were followed up by telephone at 1 month, 6 months and 1 year after discharge. CT angiography (CTA) Follow-up once a year, the clinical efficacy of its treatment and its complications. Results The success rate of surgery was 100%. Type I endoleak occurred in 4 patients (11.1%) after operation, and the internal leakage disappeared after balloon placement. One patient had neurological symptoms. There were no postoperative paraplegia and lower limb ischemia symptoms. No deaths during hospitalization. Thirty-four patients (94.4%) were followed up for a mean of 25.7 ± 25.1 months. CTAs were regularly reviewed and there was no significant increase in the false lumen with thrombus formation. Four patients died during follow-up (11.8%). Conclusion The treatment of Stanford type B with stent-graft is effective and can significantly reduce the symptoms and mortality during hospitalization. The long-term curative effect remains to be further observed.