Scheinert D, Krankenberg H, Schmidt A, Gummert J F, Nitzsche S, Scheinert S, Bräunlich S, Sorge I, Krakor R, Biamino G, Schuler G, Mohr F W
Department of Medicine/Cardiology, Clinical and Interventional Angiology, University of Leipzig - Heart Centre, Strümpellstr. 39, 04289 Leipzig, Germany.
Eur Heart J. 2004 Apr;25(8):694-700. doi: 10.1016/j.ehj.2004.02.022.
To investigate the results of endovascular stent-graft placement for the treatment of acute perforating lesions of the descending thoracic aorta.
A total of 31 consecutive patients underwent interventional treatment for perforating lesions of the descending aorta. In 21 cases (group A), the aortic perforation was due to rupture of a descending thoracic aneurysm or dissection, whereas 10 patients (group B) were treated for traumatic transection of the descending aorta. A total of 42 endoprostheses were implanted. The implantation procedure was successful in all cases without peri-interventional complications. In one case, implantation of a second endoprosthesis became necessary due to type I endoleak. Overall, the 30-day mortality was 9.7%. As all three deaths occurred in group A, the mortality rate in this group was 14.3% versus 0% in group B. Similarly, postinterventional complications were more prevalent, with 28.6% in group A (renal failure n = 4; stroke n = 2) versus 10.0% in group B (renal failure n = 1). No paraplegia and no further deaths or ruptures occurred during follow-up (mean 17 months).
Interventional stent-graft placement is an effective treatment option for the emergency repair of descending aortic perforations.
探讨血管内支架移植物置入术治疗胸降主动脉急性穿孔性病变的效果。
连续31例患者接受了降主动脉穿孔性病变的介入治疗。其中21例（A组）主动脉穿孔是由于胸降主动脉瘤破裂或夹层所致，而10例患者（B组）因降主动脉创伤性横断伤接受治疗。共植入42个血管内假体。所有病例植入过程均成功，无围介入期并发症。1例因I型内漏需要植入第二个血管内假体。总体而言，30天死亡率为9.7%。由于所有3例死亡均发生在A组，该组死亡率为14.3%，而B组为0%。同样，介入后并发症在A组更常见，为28.6%（肾衰竭4例；中风2例），而B组为10.0%（肾衰竭1例）。随访期间（平均17个月）未发生截瘫、进一步死亡或破裂。
介入性支架移植物置入术是胸降主动脉穿孔急诊修复的有效治疗选择。
