导丝间歇式后拽法在Stanford B型主动脉夹层腔内治疗中的价值

目的探讨导丝间歇式后拽法在主动脉夹层腔内治疗中的应用价值。方法回顾性总结对比187例主动脉夹层经腔内覆膜支架植入术中导丝引导输送器通过弯曲的主动脉弓时输送器单纯推送法和导丝间歇式后拽手法配合输送器推送法的效果。结果单纯推送组输送器于夹层隔膜刺出新裂口并中转手术1例,导致已植入的支架向近端移位2例,导致已植入的支架横向摆动或变形10例,输送器通过主动脉弓或支架内部受阻25例,无法进入预定部位而终止手术2例。导丝间歇式后拽 推送法仅1例支架无法进入预定部位,2例出现已植入的支架轻摆动,无其他受阻情况。结论导丝间歇式后拽法可帮助输送器顺利到达预定部位,明显提高手术成功率。

Value of intermittent guide-wire whipping technique in the procedure of endoluminal repair of aortic dissection

Objective To evaluate the technique of intermittent guide-wire whipping technique in the procedure of endoluminal repair of aortic dissections. Methods Retrospectively comparing the two methods of direct-pushing of the delivery system and the guide-wire intermittent plucking technique as the delivery system passing through the aortic arch. Results In the direct-pushing group, a new tear occurred which was pierced by the delivery system in one case, and was finally transferred to conventional operation. The implanted stent-grafts proximally migration in two cases, swing or distortion in ten cases. The delivery systems passing through the aortic arch or the lumen of the stent-grafts with much resistance in 25 cases, and did not reach the target position that resulted the procedure ending in two cases. But in the group of guide-wire plucking, only one delivery system that could not reach the target position, the implanted stent-grafts swing in two cases. No other device related blockage trouble occurred in the procedures. Conclusion The technique of intermittent guide-wire whipping is helpful in the procedure as the delivery system being carried to the target position, thus can improve the success ratio.