摘要
目的探讨腔内修复术治疗逆行撕裂的Stanford A型夹层的可行性。方法回顾性分析北京大学人民医院自2003年3月至2014年12月采用腔内修复术治疗的35例逆撕Stanford A型夹层的临床资料。男33例，女2例，年龄（46±9）岁。急性期29例，亚急性期2例，慢性期4例。夹层破口32例位于左锁骨下动脉以远，1例位于左锁骨下动脉与左颈总动脉之间，2例位于无名动脉与左颈总动脉之间。结果35例患者均成功采用覆膜支架封堵夹层原发破口，I型内漏3例（8．5％）。围术期死亡患者2例（5．7％），1例（2．9％）发生一过性轻瘫，1例（2．9％）双烟囱患者术后第5天发生假腔供血肾动脉栓塞。随访31例（88．6％），随访时间1—107个月，平均（41±19）个月。随访期间所有患者主动脉重塑良好，升主动脉无新发破口，烟囱支架及弓部桥血管通畅。结论腔内修复术是逆撕Stanford A型夹层的一种安全、可靠的治疗方法。
Objective To evaluate the feasibility of endovascular repair for retrograde type A aortic dissection. Method 35 patients of retrograde type A aortic dissection admitted to Peking University People＇s Hospital from December 2001 to March 2014 were treated with endovascular repair. There were 33 males and 2 females with mean age of 46 ± 9 years. 29 were on acute stage, 2 on subaeute stage and 4 on chronic stage. The entry tear was in the descending thoracic aorta in 32 cases,between the left subclavian artery and the left common carotid artery in one, and between the left common carotid artery and the innominate artery in two. Results Entry closure was achieved in all patients with a covered stent. 2 patients died in 30 days postoperatively （5.7%）. 1 patient with two chimney developed acute renal artery embolized which was infused by false lumin （2. 9% ）. One patient developed transient paraparesis after graft deployment（2. 9% ）. During the follow-up period, the aortic remodeling is perfect, no entry tear was noted in the ascending thoracic aorta. All the endografts for preserving supra-aortic branches were patent. Conclusions The endovascular repair for retrograde type A aortic dissection is feasible and effective.
出处
《中华普通外科杂志》
CSCD
北大核心
2015年第8期588-591,共4页
Chinese Journal of General Surgery
