带膜内支架治疗胸主动脉瘤

目的 探寻治疗胸主动脉瘤的新术式。方法 10例胸主动脉瘤病例，其中7例行单纯带膜血管内支架(stent-graft)治疗，3例夹层破裂(De Bakey I)患者行象鼻手术加带膜血管内支架置入术。结果 7例带膜血管内支架治疗组，5例成功，1例失败，1例术后死亡；3例夹层破裂手术病例均成功，恢复顺利，无并发症。结论带膜血管内支架为治疗胸降主动脉瘤的一种有效可靠方法；象鼻手术结合带膜内支架是治疗De BakeyI型的新方式，可降低手术并发症及术后病死率。

The new ways to treat the thoracic aortic aneurysms with stent-graft

Objective To report the new methods in treating thoracic aortic aneurysms.Methods In this study, there are 10 cases, which include 7 patients with aortic aneurysms, the other patients with rupture of the aortic dissection. The patients with aneurysms were treated with the endovascular stent-grafts, the patients with aortic dissection were treated by the combination of arch replacement (elephant trunk) and stent-graft placement. Results Five cases were successfully treated in the 7 cases received endovascular stent-graft ,one died from rupture of the thoracic aortic aneurysms 2 days after the stent-graft placement, in another one the placement of the stent-graft failed because of the tortuous iliac artery. Three patients treated by the combination of elephant trunk and endovascular graft recovered smoothly. Conclusion The placement of endovascular stent-graft is an effective way to treat the thoracic aortic aneurysms. Combination of the elephant trunk procedure with endovascular stent-graft should be recommended to treat De Bakey I aortic aneurysms.