Stanford B型夹层覆膜支架血管腔内修复术后围术期死亡原因分析

目的分析Stanford B型主动脉夹层覆膜支架血管腔内修复术(TEVAR)后围术期患者死亡情况及可能的死亡原因。 方法2004年2月—2012年9月，254例症状性Stanford B型主动脉夹层患者在本中心接受覆膜支架血管腔内修复术(TEVAR)治疗，其中，男性214例，女性40例，平均(51.5±12.5)岁。统计TEVAR术后围术期患者死亡情况，并分析可能的死亡原因。 结果TEVAR术后围术期患者死亡7例(7/254，2.76﹪)，其中男性5例，女性2例。可能的死亡原因中，破裂所致死亡3例(3/254，1.18﹪)，肠道缺血死亡2例(2/254，0.79﹪)，呼吸功能衰竭死亡1例(1/254，0.39﹪)，心源性猝死1例(1/254，0.39﹪)。 结论TEVAR术治疗症状性Stanford B型主动脉夹层安全、有效，但TEVAR术后围术期患者死亡情况仍需重视，在引起死亡的各种原因中，破裂和肠道缺血引起的死亡尤其值得关注。

Analysis of peri-operative cause of death about type B aortic dissection after thoracic endovascular aortic repair

ObjectiveTo analyze possible peri-operative death reason for type B aortic dissection patients after thoracic endovascular aortic repair (TEVAR). MethodsFrom Feb of 2004 to Sep of 2012, 254 patients complicated type B aortic dissection accepted TEVAR. A total of 214 male and 40 female patients were included. Average age was 51.5±12.5 years old. The peri-operative death reason for post-TEVAR were analyzed. ResultsA total of 7 patients died after TEVAR during peri-operative, including 5 male and 2 female patients. Possible reason of death included rupture (3/254, 1.18﹪), intestinal ischemia (2/254, 0.79﹪), respiratory failure (1/254, 0.39﹪) and heart failure (1/254, 0.39﹪). ConclusionsTEVAR is safe and efficient on treatment of complicated type B aortic dissection. But rupture and intestinal ischemia should be paid more attention.