摘要
目的评估真假腔途径治疗主动脉夹层术后远端瘤样扩张的早期结果。方法回顾性分析海军军医大学附属长海医院2018年4月至2019年12月10例接受真假腔干预治疗的主动脉夹层术后远端瘤样扩张患者临床资料。结果手术成功率100%,手术平均时间(126.0±38.5)min,围术期无死亡和其他并发症发生。术后平均随访时间(17.1±8.1)个月,患者内脏分支动脉均通畅,无狭窄或闭塞。1例患者因髂动脉支架闭塞再干预治疗,无主动脉相关死亡。干预后真腔直径在腹腔干、肠系膜上动脉、肾动脉和腹主动脉分叉处四个测量平面均显著升高(P<0.05);未见假腔进行性扩大,假腔直径不同程度地减少。3例患者假腔完全血栓化,1例患者胸降主动脉段假腔完全血栓化,5例患者腹主动脉假腔完全血栓化。结论真假腔干预治疗主动脉夹层术后远端瘤样扩张的早期结果满意,提供了一种新的治疗策略。
Objective To evaluate the early results of true and false lumen approach in the treatment of distal aortic enlargement after surgery of aortic dissection.Methods The clinical data of 10 patients who received true and false lumen intervention for distal aortic enlargement after surgery of aortic dissection in Changhai Hospital Affiliated to Naval Medical University from April 2018 to December 2019 were analyzed retrospectively.Results The success rate of the operation was 100%,and the average operation time was(126.0±38.5)min.There was no death or other complications during the perioperative period.The average follow-up time after operation was(17.1±8.1)months.The branch of viscera arteries were unobstructed without stenosis or occlusion.One patient received reintervention due to iliac artery stent-graft occlusion.There was no aortic-related death recorded.After the intervention,the true lumen diameter increased significantly in the four measurement planes of the celiac trunk,superior mesenteric artery,renal artery and abdominal aorta bifurcation(P<0.05).There was no progressive expansion of the false lumen,and the false lumen diameter reduced to varying degrees.The false lumen was completely thrombotic in 3 patients,the false lumen of the descending thoracic aorta was completely thrombotic in 1 patient,and the false lumen of the abdominal aorta was completely thrombotic in 5 patients.Conclusion The early results of true and false lumen intervention in the treatment of distal aortic enlargement after surgery of aortic dissection were satisfactory,which provides a new treatment strategy for patients.
作者
吴明炜
曾照祥
赵玉玺
鲍贤豪
李涛
冯家烜
冯睿
景在平
Wu Mingwei;Zeng Zhaoxiang;Zhao Yuxi;Bao Xianhao;Li Tao;Feng Jiaxuan;Feng Rui;Jing Zaiping(Department of Vascular Surgery,Changhai Hospital Affiliated to Naval Medical University,Shanghai 200433,China)
出处
《中国血管外科杂志（电子版）》
2021年第2期116-120,共5页
Chinese Journal of Vascular Surgery(Electronic Version)
基金
国家自然科学基金面上项目(81770476,81970208)。
关键词
主动脉夹层
假腔
血栓化
腔内治疗
Aortic dissection
False lumen
Thrombosis
Endovascular repair
