| 单分支支架治疗锚定区不足Stanford B型主动脉夹层 |
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| 引用本文： | 秦少华,高学军,郝庭嘉,战激光,张杰,逄晓军,赵堂海.单分支支架治疗锚定区不足Stanford B型主动脉夹层[J].中国血管外科杂志（电子版）,2019(1):28-32,36. |
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| 作者姓名： | 秦少华 高学军 郝庭嘉 战激光 张杰 逄晓军 赵堂海 |
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| 作者单位： | 滨州医学院研究生院;滨州医学院附属医院胸外科;解放军第九七〇医院血管外科 |
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| 摘 要： | 目的探讨应用Castor分支型主动脉覆膜支架治疗健康锚定区不足15 mm的Stanford B型主动脉夹层(TBAD)的临床效果。方法回顾性分析解放军第九七〇医院2017年10月至2018年6月应用Castor单分支型支架治疗18例近端健康锚定区<15 mm的TBAD患者的临床资料,其中急性TBAD 17例,慢性TBAD 1例,患者均经CT血管成像(CTA)确诊。结果手术成功率100%,手术平均时间(127.8±20.1)min,均无内漏发生,围术期无脑梗死、夹层动脉瘤破裂等并发症,无死亡病例。术中2例左锁骨下动脉(LSA)分支支架释放后存在狭窄,给予球囊扩张后狭窄解除;1例术后出现左侧肱动脉穿刺点血肿,经保守治疗治愈。随访18例,平均随访时间(8±2)个月,无截瘫及死亡病例,LSA分支支架通畅率为100%,无内漏及夹层逆撕,胸主动脉段真腔直径较术前明显扩大、假腔直径较术前明显缩小(P<0.05),胸段假腔术后血栓化率高于腹主动脉。结论 Castor分支型覆膜支架治疗近端健康锚定区不足15 mm的TBAD可以有效重建LSA,操作安全精准,隔绝效果好,短期随访无内漏发生,远期疗效尚需进一步观察。
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| 关 键 词： | 夹层 主动脉腔内修复术 分支支架 左锁骨下动脉 |
The effect of single-branched stent-graft in the treatment of Stanford B aortic dissection with insufficient landing zone |
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| QIN Shao-hua,GAO Xue-jun,HAO Ting-jia,ZHAN Ji-guang,ZHANG Jie,PANG Xiao-jun,ZHAO Tang-hai.The effect of single-branched stent-graft in the treatment of Stanford B aortic dissection with insufficient landing zone[J].Chinese Journal of Vascular Surgery(Electronic Version),2019(1):28-32,36. |
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| Authors: | QIN Shao-hua GAO Xue-jun HAO Ting-jia ZHAN Ji-guang ZHANG Jie PANG Xiao-jun ZHAO Tang-hai |
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| Institution: | (Graduate school, Binzhou Medical University, Yantai 264000, China;Department of Thoracic Surgery, Affiliated Hospital of Binzhou Medical University, Yantai 264000,China;Department of Vascular Surgery, The 970 th Hospital of PLA, Yantai 264000, China) |
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| Abstract: | QIN Shao-hua;GAO Xue-jun;HAO Ting-jia;ZHAN Ji-guang;ZHANG Jie;PANG Xiao-jun;ZHAO Tang-hai(Graduate school, Binzhou Medical University, Yantai 264000, China;Department of Thoracic Surgery, Affiliated Hospital of Binzhou Medical University, Yantai 264000,China;Department of Vascular Surgery, The 970 th Hospital of PLA, Yantai 264000, China) |
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| Keywords: | Dissection Thoracic endovascular aortic repair Branched stent Left subclavian artery |
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