摘要
目的探讨胸主动脉腔内修复术(TEVAR)治疗Stanford B型主动脉夹层的长期疗效。方法回顾性搜集300例行TEVAR治疗的Stanford B型主动脉夹层患者的临床及影像学资料,分析患者短期(在院/术后30天)及长期死亡率、并发症发生率及主动脉重塑情况。结果技术成功率100%。左锁骨下动脉完全覆盖29例,烟囱支架重建左锁骨下动脉11例,烟囱支架重建左颈总动脉7例。患者在院/术后30天死亡率0.7%(2/300),并发症发生率14%(42/300)。中位随访时间35个月(6~126个月)。1、3、5年累积全因死亡率分别为2.0%、6.7%、12.8%,主动脉夹层相关死亡率分别为1.7%、4.5%、8.4%;晚期并发症发生率14.7%(44/300),胸主动脉段假腔完全血栓化率83.7%(251/300)。结论应用覆膜血管内支架行TEVAR是治疗Stanford B型夹层安全有效的方法,长期疗效令人满意。
Objective To investigate the long-term outcomes of thoracic endovascular aortic repair(TEVAR)of Stanford type B aortic dissection.Methods The clinical and imaging data of 300 patients with Stanford B aortic dissection treated with TEVAR were analyzed retrospectively.Early(In-hospital/30-day)and late death rate,endoleak rate,complication rate and false lumen remodeling were analyzed.Results Technical success rate was 100%.The left subclavian artery(LSA)was completely covered in 29 cases,the chimney stent reconstructed the LSA in 11 cases,and the chimney stent reconstructed the left common carotid artery in 7 cases.In-hospital and 30-day rates of death and complications were 0.7%(2/300)and 14.0%(42/300),respectively.Median follow-up time was 35 months(range,6 to 126 months).The cumulative all-cause mortality rates at 1,3,and 5 years were 2.0%,6.7%,and 12.8%,respectively,and the aortic-related mortality rates were 1.7%,4.5%,and 8.4%,respectively.The rates of late complications and complete thrombosis in the thoracic aortic segment were 14.7%(44/300)and 83.7%(251/300),respectively.Conclusion Application of stent graft in TEVAR is a safe and effective method for the treatment of Stanford B type aortic dissection;and the long-term result is satisfactory.
作者
向东桥
郑传胜
梁惠民
熊斌
梁斌
王莉霞
XIANG Dongqiao;ZHENG Chuansheng;LIANG Huimin(Department of Radiology,Union Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan,Hubei Province 430022,P.R.China)
出处
《临床放射学杂志》
CSCD
北大核心
2020年第1期161-164,共4页
Journal of Clinical Radiology
关键词
动脉瘤
夹层
血管内手术
治疗效果
Aneurysm,Dissecting
Endovascular procedures
Treatment outcome
作者简介
通讯作者:王莉霞。
