85例StanfordB型主动脉夹层腔内修复治疗体会
发布时间：2018-08-19 19:55
【摘要】：目的探讨胸主动脉腔内修复术(TEVAR)治疗Stanford B型主动脉夹层(AD)方法与疗效。方法回顾性分析2010年1月至2016年4月采用TEVAR治疗的85例Stanford B型AD患者临床资料。85例患者均常规行左肱动脉穿刺,右侧股动脉直切口,升主动脉DSA造影明确AD破口位置、真假腔及与重要器官血管开口位置关系;置入覆膜血管内支架,封堵原发破口,升主动脉造影复查观察近端破口封闭情况及主动脉弓部分支血管、真假腔血流变化情况。结果 84例患者TEVAR手术成功,成功率100%;1例术前麻醉过程中突发AD破裂死亡。9例部分覆盖左锁骨下动脉,1例左锁骨下动脉"烟囱"支架完全封闭左颈总动脉和左锁骨下动脉,2例行无名动脉至左颈总动脉和左锁骨下动脉转流。Ⅰ型内漏2例,无住院期间死亡。术后随访3个月至3年,患者均存活,远端再发新破口2例。结论 TEVAR术治疗Stanford B型AD安全有效,严格把握手术指征、术中精细操作及加强术后院外管理是手术成功、提高远期生存率关键。
[Abstract]:Objective to evaluate the efficacy of endovascular thoracic aortic repair (TEVAR) in the treatment of Stanford type B aortic dissection (Stanford B). Methods the clinical data of 85 patients with Stanford type B AD treated with TEVAR from January 2010 to April 2016 were analyzed retrospectively. 85 cases of AD patients were treated with left brachial artery puncture, right femoral artery direct incision, ascending aortic DSA angiography to determine the location of AD breakage. The relationship between the true and false lumen and the position of the vascular opening in the important organs, the placement of the covered stent, the closure of the primary break, the reexamination of ascending aortography to observe the closure of the proximal break and the changes of the blood flow in the aortic arch and the true and false lumen. Results 84 patients underwent TEVAR operation successfully. Success rate 100. 1 patient died of AD rupture during anaesthesia before operation. 9 patients died partially covered with left subclavian artery. 1 patient with left subclavian artery "chimney" stents completely closed left common carotid artery and left subclavian artery. 2 cases with left unnamed artery to left subclavian artery. Common carotid artery and left subclavian artery bypass. Type 鈪，
本文编号：2192672
[Abstract]:Objective to evaluate the efficacy of endovascular thoracic aortic repair (TEVAR) in the treatment of Stanford type B aortic dissection (Stanford B). Methods the clinical data of 85 patients with Stanford type B AD treated with TEVAR from January 2010 to April 2016 were analyzed retrospectively. 85 cases of AD patients were treated with left brachial artery puncture, right femoral artery direct incision, ascending aortic DSA angiography to determine the location of AD breakage. The relationship between the true and false lumen and the position of the vascular opening in the important organs, the placement of the covered stent, the closure of the primary break, the reexamination of ascending aortography to observe the closure of the proximal break and the changes of the blood flow in the aortic arch and the true and false lumen. Results 84 patients underwent TEVAR operation successfully. Success rate 100. 1 patient died of AD rupture during anaesthesia before operation. 9 patients died partially covered with left subclavian artery. 1 patient with left subclavian artery "chimney" stents completely closed left common carotid artery and left subclavian artery. 2 cases with left unnamed artery to left subclavian artery. Common carotid artery and left subclavian artery bypass. Type 鈪，
本文编号：2192672
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