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|本期目录/Table of Contents|

胸主动脉腔内隔绝术治疗DeBakey Ⅲb型夹层动脉瘤的效果

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2010年第1期
页码:
86-88
栏目:
临床研究
出版日期:
2010-01-04

文章信息/Info

Title:
Evaluation of endovascular graft exclusion in treatment of DeBakey type IIIb thoracic aortic dissecting aneurysm
作者:
朱鹏; 廖崇先; 强海峰; 邱风; 杨谦
厦门大学附属中山医院心外科，福建 厦门 361000
Author(s):
ZHU Peng;  LIAO Chong-xian;  QIANG Hai-feng;  QIU Feng;  YANG Qian
Department of Cardiovascular Surgery, Zhongshan Hospital, Xiamen University, Xiamen 361000, Fujian, China
关键词:
动脉瘤; 夹层; 腔内隔绝术
Keywords:
dissecting aneurysm;  endovascular stent graft
分类号:
R543.16
DOI:
-
文献标识码:
A
摘要:
目的: 观察胸主动脉腔内修复（EVR）治疗胸主动脉夹层动脉瘤的方法和疗效。方法: 15例DeBakey Ⅲb型胸主动脉夹层患者行腔内隔绝术。术后对所有患者行CT随访，评价其临床改善程度与真假腔的变化。结果: 15例患者全麻下均成功进行了覆膜支架胸主动脉腔内隔绝术，术中造影显示夹层动脉瘤裂口完全封闭或内漏明显较少。术后1～22个月随访，术后30 d内死亡1例，1例术后出现左下肢体运动障碍，余13例无明显术后并发症。结论: 胸主动脉腔内隔绝术治疗DeBakey Ⅲb型夹层动脉瘤并发症少，术后恢复较好。
Abstract:
AIM: To observe surgical techniques and therapeutic effects of endovascular stent graft exclusion in DeBakey type Ⅲb aortic dissecting aneurysm. METHODS: Fifteen patients with thoracic aortic dissection (TAD) were treated by endovascular graft exclusion (EVGE). Clinical and computed tomography outcome were analyzed during follow-up. RESULTS: Successful operation was performed in all cases with compete disappearance of the false lumen or remarkable decrease of the endoleak on the angiograms after stent placement. At 2-37 months follow-up, there was one death and one left limb palsy, with no other significant complications in the remaining patients. CONCLUSION: EVGE, with fewer complications and quicker recovery, has good therapeutic effects in treating patients with DeBakey type Ⅲb aortic dissection.

参考文献/References

［1］ Kato N, Shimono T, Hirano T, et al. Transluminal placement of endovascular stent graft for the treatment of type A aortic dissection with an entry tear in the descending thoracic aorta［J］. J Vasc Surg, 2001, 34(6):1023-1028.

［2］ Gysi J, Schaffner T, Mohacsi P, et al. Early and late outcome of operated and non-operated acute dissection of the descending aorta［J］. Eur J Cardiothorac Surg, 1997, 11(6):1163-1169.

［3］ Akutsu K, Nejima J, Kiuchi K, et al. Effects of the patient false lumen on the long-term outcome of type B acute aortic dissection［J］. Eur J Cardiothorac Surg, 2004, 26(2):359-366.

［4］ Mcphee JT, Asham EH, Rohrer MJ, et al. The mid term results of stent graft treatment of thoracic aortic injuries［J］. J Surg Res, 2007, 138(2):181-188.

［5］ Dake MD, Kato N, Mitchell RS, et al. Endovascular stent-graft placement for treatment of acute aortic dissection［J］. N Engl J Med, 1999, 340(20):1546-1552.

［6］ Nienaber CA, Fattori R, Lund G, et al. Nonsurgical reconstruction of thoracic aortic dissection by stent-graft placement［J］. N Engl J Med, 1999, 340(20):1539-1545.

［7］ Doss M, Balzer J, Martens S, et al. Surgical versus endovascular treatment of acute thoracic aortic rupture:a singer-center experience［J］. Ann Thorac Surg, 2003, 76(5):1465-1469.

备注/Memo

备注/Memo:
收稿日期：2008-1-22.作者简介:朱鹏，住院医生，硕士Email：doctff@126.com
更新日期/Last Update: 2010-01-05