论文部分内容阅读
目的观察覆膜血管内支架治疗StanfordB型主动脉夹层的方法和临床疗效。方法对2007年3月至2011年10月36例StanfordB型主动脉夹层实施覆膜血管内支架治疗患者的临床资料进行回顾性分析。结果本组36例腔内隔绝术均获成功。1例术后造影显示出现轻微内漏,3个月后复查显示内漏消失;1例术中部分封闭左锁骨下动脉开口;1例术前并发脑梗死的患者术后经高压氧治疗后痊愈;1例术后并发肺部感染,经气管切开及呼吸机辅助呼吸等治疗后痊愈。全组无死亡病例,无截瘫、器官缺血、血栓形成等相关并发症发生。29例术后获随访3～24个月,复查主动脉CT显示夹层真腔明显增大,假腔明显缩小,覆膜支架位置、形态保持正常,无支架移位及内漏。结论覆膜血管内支架治疗StanfordB型主动脉夹层具有安全、有效、创伤小、严重并发症少等优势,近期疗效令人满意,远期疗效还有待更长的随访。
Objective To observe the method and clinical efficacy of endovascular stent graft treatment of Stanford type B aortic dissection. Methods The clinical data of 36 patients with Stanford type B aortic dissection treated with endovascular stent graft from March 2007 to October 2011 were analyzed retrospectively. Results 36 cases of endovascular exclusion in this group were successful. A case of postoperative angiography showed a slight endoleak, and a retrospective examination after 3 months showed disappearance of the endoleak. One case was partially closed with an opening of the left subclavian artery. One case of preoperative cerebral infarction was cured after hyperbaric oxygen therapy One patient had pulmonary infection after operation, and was cured after tracheotomy and ventilator assisted breathing. The whole group without deaths, no paraplegia, organ ischemia, thrombosis and other related complications. Twenty-nine patients were followed up for 3 to 24 months. Aortic CT examination showed that the true lumen of the intervertebral disc was significantly enlarged, the false lumen was significantly reduced, and the position and shape of the stent graft remained normal without stent displacement and endoleak. Conclusion Endovascular stent-graft treatment of Stanford type B aortic dissection is safe, effective, less traumatic and less serious complications, the recent satisfactory results, long-term efficacy remains to be followed up for a long time.