腔内修复主动脉弓动脉瘤或夹层动脉瘤14例

目的探讨腔内修复主动脉弓动脉瘤或夹层动脉瘤的疗效。方法回顾性分析2003年6月至2004年8月腔内修复主动脉弓动脉瘤或夹层动脉瘤14例的临床资料。其中,DebakeyⅢ型主动脉夹层动脉瘤(aorticdissectionaneurysm, ADA)12例,动脉瘤2例。8例ADA直接行腔内修复,覆盖左锁骨下动脉开口;另4例ADA和2例动脉瘤接受辅助性右左颈总动脉、左颈总左锁骨下动脉旁路联合腔内修复。结果14例均取得技术成功。1例动脉瘤患者腔内修复术后并发缺血性脑卒中死亡。生存的13例围手术期和随访期间(1 ~14个月,平均11个月)无神经系统或肢体缺血性并发症。3个月CT证实所有ADA患者原发破口封闭。存活动脉瘤患者术后1个月CT显示瘤腔内血栓形成。结论腔内修复主动脉弓动脉瘤或夹层动脉瘤是安全、有效的。

Endovascular repair of aneurysms or dissection aneurysms of the aortic arch-preliminary experiences in 14 cases

Objective To evaluate the efficacy of endovascular repair (EVR) for aneurysms or dissection aneurysms of the aortic arch. Methods Twelve aortic dissection aneurysm (ADA) patients with the primary entry located within 15 mm beyond the origin of the left subclavian artery (LSA) and two aortic arch aneurysm patients underwent EVR from June 2003 to August 2004. EVR with intentional coverage of the LSA without any supportive bypass was employed in 8 ADA patients, and the preliminary cervical reconstruction combined with EVR in the remaining 6 cases. Results Technical success was achieved in all cases. One case died of postoperative cerebral infarction. No neurological deficits or limb ischemia developed perioperatively or during the follow up period raging from 1 to 14 months and complete thrombosis of the thoracic aortic false lumen and remarkable anenrysmal thrombosis were revealed by CT in all 12 ADA cases and the remaining aneurysm case respectively. Conclusions EVR is effective in the management of aneurysms or dissection aneurysms of the aortic arch.