Department of Vascular and Endovascular Surgery, Changzheng Hospital, Naval Medical University, Shanghai, China.
Ann Thorac Cardiovasc Surg. 2021 Jun 20;27(3):200-206. doi: 10.5761/atcs.oa.20-00383. Epub 2021 Apr 14.
To evaluate the safety and efficacy of a novel vascular-friendly thoracic stent graft for patients with acute complicated type B aortic dissection (ac-TBAD).
A multicenter retrospective study was undertaken in which we prospectively collected data in consecutive ac-TBAD patients treated by thoracic endovascular aortic repair (TEVAR) with the Ankura Thoracic Stent. Complications, true lumen rate (TLR), and mortality were recorded. Follow-up computed tomography angiography (CTA) was performed at 1, 6, and 12 months postoperatively and yearly thereafter.
Altogether, 63 patients with ac-TBAD in four medical centers were included. No deaths or serious complications occurred during the perioperative period. The mean follow-up time was 30.1 ± 18.9 months. All-cause mortality rate was 3.1% (n = 2). TEVAR-related mortality rate was 1.6% (n = 1) because of retrograde type A dissection (RTAD) at 6 months. The other death was caused by acute myocardial infarction (AMI) during the third postoperative month. A distal endoleak detected at 3 months in one patient (1.6%) was treated by reintervention. The use of this novel vascular-friendly thoracic stent graft in ac-TBAD postoperative patients significantly improved their TLR.
The novel vascular-friendly thoracic stent graft showed satisfactory results, with favorable stability of the aortic diameter during follow-up.
评估一种新型血管友好型胸主动脉支架移植物在急性复杂型 B 型主动脉夹层（ac-TBAD）患者中的安全性和有效性。
进行了一项多中心回顾性研究，前瞻性收集了 63 例采用 Ankura 胸主动脉支架进行胸主动脉腔内修复术（TEVAR）治疗的 ac-TBAD 患者的数据。记录并发症、真腔率（TLR）和死亡率。术后 1、6 和 12 个月以及此后每年进行随访计算机断层血管造影（CTA）。
共有来自四个医学中心的 63 例 ac-TBAD 患者纳入本研究。围手术期无死亡或严重并发症发生。平均随访时间为 30.1 ± 18.9 个月。全因死亡率为 3.1%（n=2）。1 例患者（1.6%）在术后 6 个月因逆行性 A 型夹层（RTAD）发生 TEVAR 相关死亡。另 1 例死亡发生在术后第 3 个月，死因是急性心肌梗死（AMI）。1 例患者在术后 3 个月发现远端内漏（1.6%），经再次介入治疗得到治愈。在 ac-TBAD 术后患者中使用这种新型血管友好型胸主动脉支架移植物显著提高了 TLR。
新型血管友好型胸主动脉支架移植物具有良好的稳定性，在随访期间对主动脉直径的稳定效果良好，结果令人满意。
