摘要
目的探讨杂交技术治疗主动脉弓部病变的近、远期结果。方法将我科2002年10月至2011年3月期间的28例胸主动脉瘤或夹层累及主动脉弓的患者纳入本研究。男22例,女6例;平均年龄68岁。15例为动脉粥样硬化性胸主动脉瘤,13例为主动脉夹层。术后3、6、12个月及每年进行CT血管造影或B超随访。主要研究内容是手术死亡率、并发症发生率及远期生存率。结果 12例开胸行全弓旁路术,左侧颈总-左侧锁骨下动脉旁路3例,右侧颈总-左侧颈总-左侧锁骨下动脉旁路11例,右侧颈总-左侧颈总动脉旁路2例。技术成功率为92.9%(26/28),并发症发生率为35.7%(10/28),手术死亡率为7.1%(2/28),脑卒中发生率为7.1%(2/28)。随访时间(36±3)个月,1年通畅率为100%,3年通畅率为92.9%(26/28),5年通畅率85.7%(24/28);1年生存率为89.3%(25/28),3年生存率为71.4%(20/28),5年生存率为60.7%(17/28)。结论主动脉夹层弓部病变杂交手术的近、远期结果满意,进一步降低并发症发生率将会提高患者生存率。
Objective To evaluate the short-and long-term results of hybrid procedures in the treatment for aortic arch lesions. Methods From October 2002 to March 2011,28 patients with thoracic aortic aneurysms or dissections involving the aortic arch were treated with hybrid endovascular treatment in our center.Twenty-two males and 6 females were in the series.The mean age of the patients was 68 years old.Of 28 patients,15 were atherosclerotic thoracic aortic aneurysms and 13 were thoracic aortic dissection.Follow-up protocol consisted of computed tomography（CT） angiograms or ultrasound was performed in 3,6,and 12 months,and annually thereafter.The main goal was to evaluate the operative mortality,morbidity,and the long-term survival of these patients. Results Hybrid procedures included 12 total-arch transpositions,3 left common carotid artery（LCCA）-left subclavian artery（LSA） bypass,11 right common carotid artery（RCCA）-LCCA-LSA bypass,2 RCCA-LCCA bypass.The technical success rate was 92.9%（26/28）.The complications occurred in 10 patients（35.7%）.Operative mortality was 7.1%（2/28）.The apoplexia rate was 7.1%（2/28）.The time of follow-up was（36±3） months.The patency rates of 1-year,3-year,and 5-year were 100%,92.9%（26/28）,and 85.7%（24/28）,respectively.The survival rates of 1-year,3-year,and 5-year were 89.3%（25/28）,71.4%（20/28）,and 60.7%（17/28）,respectively. Conclusions The short-and long-term results with hybrid procedures in the treatment for aortic arch diseases are satisfactory.Further reducing the complications is the key to increase the survival rate.
出处
《中国普外基础与临床杂志》
CAS
2011年第10期1039-1042,共4页
Chinese Journal of Bases and Clinics In General Surgery
关键词
胸主动脉瘤
主动脉夹层
主动脉弓
杂交手术
血管腔内治疗
Thoracic aortic aneurysms
Aortic dissection
Aortic arch
Hybrid procedures
Endovascular repair
