Chen Lei, Yang Sheng-Jia, Guo Feng-Ling, Zhang Qing-Yun, Yang Zhi
Department of Vascular Surgery, Chengde Medical University Affiliated Hospital, China.
Department of Vascular Surgery, Xuan Wu Hospital, Capital Medical University, Beijing, China.
Adv Clin Exp Med. 2018 Sep;27(9):1259-1262. doi: 10.17219/acem/70453.
Thoracic endovascular aortic repair (TEVAR) has been frequently applied in Stanford type B aortic dissection since thoracic aortic diseases were first treated with artificial vessels.
The aim of this study was to analyze the clinical value of TEVAR applied in treating Stanford type B aortic dissection.
Between January 2007 and April 2014, 167 consecutive Stanford type B aortic dissection patients were treated with TEVAR and retrospectively analyzed.
All patients had a successful operation. A total of 98 patients were followed-up and the duration of the follow-up ranged from 3 to 63 months with a mean of 25.6 ±8.4 months. Proximal type I endoleak occurred in 18 patients with an incidence rate of 18.37% and a cuff was deployed in 7 patients, in whom the endoleak disappeared after 3 months. Two patients died in the perioperative period: one died from aortic dissection rupture, while the other died from infectious shock. One patient died from acute myocardial infarction during the follow-up period. Tears occurred in the end piece of stent grafts in 12 patients, and additional TEVAR was performed. One patient had a proximal retrograde type A dissection; the patient was in an acceptable state of health apart from persistent chest and back pain, and is still in follow-up. Spinal cord ischemia, stent displacement and collapse did not occur.
TEVAR is reliable and safe, and it can be widely applied in treating Stanford type B aortic dissection.
自从胸主动脉疾病首次采用人工血管治疗以来，胸主动脉腔内修复术（TEVAR）已频繁应用于Stanford B型主动脉夹层。
本研究旨在分析TEVAR应用于治疗Stanford B型主动脉夹层的临床价值。
2007年1月至2014年4月，连续167例Stanford B型主动脉夹层患者接受TEVAR治疗并进行回顾性分析。
所有患者手术均成功。共98例患者获得随访，随访时间3至63个月，平均（25.6±8.4）个月。18例发生I型近端内漏，发生率为18.37%，其中7例置入封堵器，3个月后内漏消失。围手术期死亡2例：1例死于主动脉夹层破裂，另1例死于感染性休克。随访期间1例死于急性心肌梗死。12例支架移植物末端出现撕裂，再次行TEVAR治疗。1例发生近端逆行A型夹层，除持续胸背部疼痛外，患者健康状况尚可，仍在随访中。未发生脊髓缺血、支架移位及塌陷。
TEVAR可靠、安全，可广泛应用于Stanford B型主动脉夹层的治疗。
