丁国文, 陈锁成, 董长青, 施益军, 邵爱中. 主动脉支架植入术治疗胸主动脉疾病的效果[J]. 心脏杂志, 2012, 24(5): 642-645.
    引用本文: 丁国文, 陈锁成, 董长青, 施益军, 邵爱中. 主动脉支架植入术治疗胸主动脉疾病的效果[J]. 心脏杂志, 2012, 24(5): 642-645.
    Stent grafting for thoracic aortic diseases[J]. Chinese Heart Journal, 2012, 24(5): 642-645.
    Citation: Stent grafting for thoracic aortic diseases[J]. Chinese Heart Journal, 2012, 24(5): 642-645.

    主动脉支架植入术治疗胸主动脉疾病的效果

    Stent grafting for thoracic aortic diseases

    • 摘要: 目的:探讨胸主动脉疾病支架植入术治疗的适应证和疗效。方法: 对79例胸主动脉疾病行主动脉支架植入的疗效进行回顾性分析。79例患者中,Stanford A型主动脉夹层动脉瘤18例,Stanford B型主动脉夹层动脉瘤49例;主动脉瘤5例;外伤性胸主动脉破裂7例。术前采用CT血管造影(CTA)或磁共振血管造影(MRA)对主动脉进行评估。18例Stanford A型主动脉夹层动脉瘤患者行术中支架置入,其余61例患者在数字减影血管造影(DSA)下经股动脉或髂动脉行支架腔内隔绝术。结果: 内漏8例(10%),4例于术后3月内自行闭合,1例再次腔内隔绝治疗,3例未进一步治疗;死亡8例(10%)均在术后1月内,其中3例死于神经系统并发症, 4例死于严重的合并症,1例死于主动脉瘤破裂。随访生存3年以上7例(9%),2年以上14例(18%),1年以上26例(33%),1年以内24例(30%)。结论: 主动脉支架植入术可减少手术风险,降低病死率,广泛适用于各种胸主动脉疾病。

       

      Abstract: AIM:To evaluate the operation indications and effectiveness of stent grafting for aortic diseases. METHODS: From November, 2007 to November, 2011, endovascular stent-graft exclusion for aortic diseases was preformed in 79 patients. Among them, 18 cases were Stanford A aortic dissection, 49 were Stanford B aortic dissection, 5 cases were aortic aneurysm, and 7 cases were traumatic thoracic aortic rupture. CTA or MRA were used as preoperative evaluation methods. 18 cases of Stanford A aortic dissection were treated with stent-graft during the operation, the rest of the patients were performed endovascular exclusion under DSA guidance. RESULTS: Eight patients (10%) were with endoleak among them, four were self-closed within 3 months, one was re-operated, the others did not accept further therapy. Eight cases (10%) died within one month after operation, three of which died of neurological complications, four died of severe complications, one died of aortic aneurysm rupture. Seven patients (9%) had survived more than 3 years, 14(18%) more than 2 years, 26 (33%) more than 1 year, and the remaining 24 (30%) patients less than one year. CONCLUSION: The indications of stent grafting for aortic diseases.are extensive, which can improves the treatment of thoracic aortic disease and reduces mortality.

       

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