摘要
目的 探讨复杂Stanford B型胸主动脉夹层治疗的最佳治疗方法及临床效果.方法 选取我院2003年1月至2014年1月共46例复杂Stanford B型胸主动脉夹层行覆膜支架腔内植入术患者,其中男性41例,女性5例,年龄33～64岁,平均45岁.16例采用2枚支架植入术,30例应用长直筒支架.术后1、3、6、12个月及以后每年均行CTA复查,比较两组内漏发生率、围手术期有无脊髓缺血、假腔血栓化及支架远端有无并发症.结果 46例患者中有2例发生急性脊髓缺血导致截瘫,远端支架贴附不良1例,支架远端相关并发症4例均为放置长直筒支架患者,无支架内漏及移位,无脑梗死及脏器缺血等并发症.所有患者无死亡.结论 采用2枚支架植入术避免了现有支架长度及直径的限制,可根据Stanford B型胸主动脉夹层患者不同特点制订腔内修复治疗方案.此方法适用、可行,避免支架与主动脉远端直径不匹配引起远期并发症.
Objective To study the best treatment method and clinical effect of treatment in complicated Stanford type B aortic dissection. Methods From January 2003 to January 2014, a total of 46 cases of complex Stanford type B thoracic aortic dissection of coated stent lumen implantation, 41 cases of men and women in 5 cases, age 33-64, an average of 45. 16 cases with 2 pieces of stent implantation, 30 cases of application of long straight stents. They were followed postoperative 1, 3, 6, 12 months, and after that followed the row CTA each year. The leakage rate, perioperative presence of spinal cord ischemia, the false lumen thrombosis and distal stent with and without complications were compared. Results 2 cases occurred with acute spinal cord ischemia resulting in paraplegia, 1 with distal stent attached had. 4 cases of distal stent related complications were happened in straight stents, but no stent leakage, no stent displacement, no complications such as ischemic cerebral infarction and organs. No deaths were happened. Conclusion Using of two stents implantation may avoid the restrictions of the existing bracket length and diameter, and helpful in making intracavitary repair treatment plan according to dif- ferent characteristics of Stanford type B aortic dissection. This method is applicable and feasible in avoiding the long-term complications for mismatch of bracket and distal aortic diameter.
出处
《中国心血管病研究》
CAS
2015年第1期85-88,95,共5页
Chinese Journal of Cardiovascular Research
