摘要
目的观察逆行性A型主动脉夹层的腔内隔绝治疗效果,探讨逆行性A型主动脉夹层腔内隔绝治疗的策略。方法选取湖南中医药大学第一附属医院2016年10月至2020年11月近端内膜破口位于降主动脉的逆行性A型主动脉夹层患者19例,行主动脉覆膜支架植入术,并于术后1周、3个月、半年、1年随访观察治疗效果。结果全组随访无一例患者死亡,2例患者支架近端主动脉弓部出现局限性溃疡,2例出现升主动脉夹层,1例支架远端出现夹层,其余14例患者均恢复良好,无相关并发症。结论近端内膜破口位于降主动脉的逆行性A型主动脉夹层患者,经保守治疗后择期行腔内隔绝手术的治疗策略近中期效果理想。
Objective To discuss the therapeutic effect and the therapeutic strategy of endovascular isolation for the treatment of retrograde type A aortic dissection.Methods A total of 19 patients suffered from retrograde type A aortic dissection with its proximal intimal tear locating at the descending aorta,who were admitted to the First Affiliated Hospital of Hunan University of Traditional Chinese Medicine of China between October 2016 and November 2020,were enrolled in this study.Aortic covered stent implantation was performed in all the 19 patients.The patients were followed up,and the postoperative one-week,3-month,6-month and 12-month curative effects were evaluated.Results During the follow-up period,no death occurred.Two patients developed localized ulcer at the aortic arch proximal to the stent,2 patients developed ascending aortic dissection,and one patient developed aortic dissection distal to the stent.All the remaining 14 patients recovered well,and no procedure-related complications occurred.Conclusion For patients suffered from retrograde type A aortic dissection with its proximal intimal tear locating at the descending aorta,the therapeutic strategy of conservative treatment followed by endovascular isolation within a short time period carries satisfactory short-to-mid-term effect.
作者
张胜康
尹晓清
徐朝军
王兆礼
杨进
程宇
ZHANG Shengkang;YIN Xiaoqing;XU Zhaojun;WANG Zhaoli;YANG Jin;CHENG Yu(Department of Cardiothoracic Surgery,First Affiliated Hospital of Hunan University of Traditional Chinese Medicine,Changsha,Hunan Province 410007,China)
出处
《介入放射学杂志》
CSCD
北大核心
2023年第10期1006-1009,共4页
Journal of Interventional Radiology
基金
湖南省教育厅科学研究项目(20A364)。
关键词
逆行性A型主动脉夹层
升主动脉血肿
主动脉覆膜支架植入
腔内修复
retrograde type A aortic dissection
ascending aorta hematoma
aortic covered stent implantation
endovascular repair
