人造血管覆盖支架腔内治疗胸主动脉夹层动脉瘤

目的 总结人造血管覆盖支架腔内治疗胸主动脉夹层动脉瘤的经验。方法 术前行CTA或MRA检查进行影像学评估。手术在DSA监视下进行，对29例StanfordB型胸主动脉夹层动脉瘤施行了人造血管覆盖支架腔内治疗，封闭夹层入口。术后随访期间行CT检查观察手术效果、假腔内血栓形成情况、有无内漏及支架移位等并发症。结果 29例手术均获成功，术后均无内漏、无截瘫，术后第10d猝死1例，随访期间猝死1例，其余病例均健康生存，假腔内血栓形成．无支架移位情况发生。结论 人造血管覆盖支架腔内治疗胸主动脉夹层动脉瘤具有微创、有效、严重并发症少，恢复快的优点。其近期一中期疗效令人满意，远期效果有待继续随访观察。

Translnminal stent-graft placement for the treatment of thoracic aortic dissection

Objective To sum up experience in transluminal stent-graft placement for the treatment of thoracic aortic dissection. Methods CT or MRI were used as preoperative evaluation methods. Twenty-nine patients with Stanford-B aortic dissection underwent transluminal stent-graft placement with the guidance of DSA. All cases sealed the primary entry tears. Follow-up by CT to observe the efficacy, thrombosis in false lumen, and complications such as endoleak and migration of stent-graft. Results Placement of transluminal stent-graft across the primary entry tears was technically successful in all 29 patients, with no leakage and no instance of paraplegia. One patient died within the perioperative period, another patient died during the follow-up. The others were in good state, complete or partial thrombosis of the thoracic aortic false lumen was achieved and no instances of migration of stent-graft. Conclusion Transluminal stent-graft placement for the treatment of thoracic aortic dissection has the advantage of micro-invasion, efficacy, less severe complications and quick recovery. Further follow-up is necessary to evaluate its long-term efficacy.