覆膜支架主动脉腔内修复术在Stanford B型主动脉夹层中的应用

目的观察覆膜支架主动脉腔内修复术（TEVAR）对Stanford B型主动脉夹层和降主动脉瘤的治疗效果。方法回顾性分析华西医院2013年3～6月采用TEVAR治疗Stanford B型主动脉夹层和降主动脉瘤患者20例的临床资料，其中男19例，女1例；年龄41～76（58．3±10．2）岁，分析其疗效。结果20例患者中，治愈18例，自动出院1例，术后死亡1例。随访满3个月者16例，随访率88．9％。全部随访患者支架范同内真腔管径有所恢复，假腔或瘤腔内血栓形成。结论TEVAR为Stanford B型主动脉瘤提供了一个新的选择，特别是为高龄和合并严重疾病的患者提供了新的治疗手段，优势明显，值得临床应用。

12 Thoracic Endovascular Aortic Repair for Stanford Type B Aortic Dissection

Objective To evaluate clinical outcomes of thoracic endovascular aortic repair （TEVAR） for the treatment of Stanford type B aortic dissection （AD） and descending aortic aneurysm. Methods Clinical data of 20 patients with Stanford type BAD or descending aortic aneurysm who underwent TEVAR in West China Hospital from March to June 2013 were retrospectively analyzed. There were 19 male and 1 female patients with their age of 41-76 （ 58.3 ± 10.2 ） years. Clinical outcomes were analyzed. Results Among the 20 patients, 18 patients were successfully discharged, 1 patient refused further postoperative treatment and was discharged, and 1 patient died postoperatively. Sixteen patients （88.9%） were followed up for over 3 months. In all the patients during follow-up, true lumen diameter recovered within the scope of intravascular stents, and there was thrombosis in false lumen or aneurysm lumen. Conclusion TEVAR provides a new choice with significant advantages for the treatment of Stanford type BAD, especially for the elderly and patients with concomitant serious diseases, so it is worthy of clinical application.