左锁骨下动脉“烟囱”技术在胸主动脉夹层腔内修复术中的应用

发布时间：2018-06-03 04:21

本文选题：主动脉夹层 + 覆膜支架植入　；参考：《介入放射学杂志》2015年08期

【摘要】：目的探讨左锁骨下动脉"烟囱"技术在Stanford B型胸主动脉夹层腔内修复术(TEVAR)中的应用及技术要点。方法回顾分析35例临床和影像学确诊为主动脉撕裂累及左锁骨下动脉(第一破口距左锁骨下动脉开口15 mm)、左椎动脉优势或Willis环代偿不足的Stanford B型胸主动脉夹层患者,以CTA、DSA作为评估方法。TEVAR术中覆膜支架覆盖左锁骨下动脉,"烟囱"技术植入球囊扩张支架重建左锁骨下动脉。结果 35例胸主动脉覆膜支架及左锁骨下动脉球囊扩张支架均植入成功。术后随访3~24个月,35例左锁骨下动脉"烟囱"支架通畅率为100%。结论 TEVAR修复Stanford B型胸主动脉夹层手术中覆膜支架近侧锚定区选择在正常主动脉壁可降低继发性医源性夹层发生。左锁骨下动脉"烟囱"技术联合TEVAR是修复撕裂累及左锁骨下动脉的Stanford B型胸主动脉夹层的安全、有效方法,可有效地预防盗血综合征发生。
[Abstract]:Objective to investigate the application of left subclavian artery chimney technique in Stanford B thoracic aortic dissection. Methods 35 patients with aortic avulsion involving left subclavian artery (15 mm from the first break to the left subclavian artery, superior left vertebral artery or insufficient compensation of Willis ring) were retrospectively analyzed in 35 patients with aortic dissection of type B thoracic aorta. The left subclavian artery was covered with a covered stent during TEVAR. The "chimney" technique was implanted into a balloon dilated stent to reconstruct the left subclavian artery. Results 35 cases of thoracic aorta covered stents and left subclavian artery balloon dilated stents were successfully implanted. 35 cases of left subclavian artery stents were followed up for 3 ~ 24 months. Conclusion during TEVAR repair of Stanford B thoracic aortic dissection, the choice of proximal anchoring area in normal aortic wall can reduce the occurrence of secondary iatrogenic dissection. The technique of "chimney" of left subclavian artery combined with TEVAR is a safe and effective method for repairing Stanford type B thoracic aortic dissection which is torn and involved in left subclavian artery, and can effectively prevent the occurrence of steal syndrome.
【作者单位】：广州医科大学附属第二医院放射科;广州医科大学附属第二医院血管外科;
【分类号】：R654.3;R816.2

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