102例Stanford B型主动脉夹层动脉瘤的腔内治疗经验

目的　总结StanfordB型主动脉夹层动脉瘤腔内治疗的经验。方法　术前对患者进行多种影像学检查 ,获得主动脉夹层动脉瘤的解剖学资料。术中在DSA监视下对 1 0 2例StanfordB型主动脉夹层动脉瘤施行了人工血管内支架移植术。术后 1周和术后 1年行螺旋CT检查 ,观察手术疗效以及有无内漏、移位和人工血管内支架塌陷等术后并发症。结果　 1 0 1例 (99 .0 %)临床成功 ,1例(1 . 0 %)于围手术期内死亡。无术后截瘫。 1 8例 (1 7. 6 %)发生内漏。结论　腔内治疗StanfordB型主动脉夹层动脉瘤具有创伤小 ,严重并发症少 ,住院时间短的优势。近期和中期疗效令人满意。

Endovascular therapy of Stanford type B abdominal aortic dissection in 102 cases

Objective To sum up our experience in endovascular therapy of Stanford type B abdominal aortic dissection (AAD) in 102 cases. Methods Diagnosis and typing of AAD were established by multiple imaging examinations. Stent-grafts were implanted with the guidance of DSA in 102 cases of Stanford B AAD. Follow-up by CT was performed 1 week and 1 year postoperatively to observe the efficacy and complications such as endoleak, migration and fracture of stent-graft. Results The procedure was successful in 99.0% AAD patients. One patient died perioperatively. No postoperative paraplegia has occurred. Endoleak occurred in 18 cases (17.6%). Conclusion Endovascular therapy of Stanford type B abdominal aortic dissection has the advartage of micro-invasion, less severe complications, short hospital stay in contrast to traditional operation. Long term follow-up is required for the final evaluation of this procedure.