带膜血管内支架在治疗胸主动脉夹层中的应用

目的:总结带膜血管内支架置入治疗DebakeyⅢ型主动脉夹层临床经验。方法:胸主动脉夹层8例,男6例,女2例,平均年龄(54.2±10.6)岁。经CT增强扫描或磁共振成像确诊。切开右或左侧股动脉置入带膜血管内支架,封堵原发破口。置入后重复造影检查。随访行胸部X线平片与电子束CT检查。结果:支架置入全部成功,术后即刻造影7例无内漏,1例见少量内漏。降主动脉及腹主动脉真腔均明显扩大,远端降主动脉及分支供血均有不同程度的改善。术后随访:降主动脉及腹主动脉真腔扩大,术后造影1例有内漏者,无加重,其余患者近端夹层动脉瘤消失,夹层近端假腔内均有血栓形成。结论:带膜血管内支架置入治疗胸主动脉夹层近期疗效满意,远期疗效有待于进一步观察。

Endovascular stent-graft treatment of thoracic aortic dissections

Objective To investigate the clinic results of endovascular stent-graft treatment for the thoracic aortic dissection. Method Eight patients with thoracic aortic dissection were diagnosed by contrast enhanced CT or MRI,including six men and two women and mean age was 54.2±10.6 years. Vascular access was obtained through femoral artery after surgical arteriotomy and stent-graft was deployed in the true lumen to occlude the primary entry tear. Immediate aortography was performed after procedure and the follow-up data about X-ray and EBCT were evaluated. Results Stent-graft deployment was successfully performed. Immediate aortography after procedure showed no leakage in seven patients and minor leakage in one patient. The diameters of thoracic and abdominal aortic true lumen increased significantly. Improvements of the blood flow in the distal aorta were achieved and abdominal branch vessels also had a good perfusion. The serial follow-up data demonstrated that true lumen of thoracic and abdominal aorta were enlarged and the leakage was not aggravated , the double-chamber of the thoracic aorta dissappeared and thrombosis in the thoracic aortic false lumen were exhibited in all patients. Conclusion Endovascular stent-graft deployment may be an effective treatment for thoracic aortic dissections. Further study will be needed for evaluation of long-term results .