201502077论着主动脉分区在主动脉夹层腔内治疗方式选择中的意义.doc

DOI：10.16016/j.1000-5404.201502077 201502077 论著 Significance of Thoracic aortic partition in endovascular repair of thoracic aortic dissection Ding Sheng， Zhang Jinbao， Zhang Liping，Ouyang ui， Gao feng， Wu XiaochenChengdu Military General Hospital， Chengdu， Sichuan Province 610083， China [Abstract] Objective　 To investigate the significance of the aorta partition in endovascular repair of thoracic aortic dissection with diferent type. Methods　 January 2009 to January 2015， a total of 208 patients were successfully completed stent grafts implantation via femoral artery， and bypasses were established between aorta to brachiocephalic artery or brachiocephalic artery to brachiocephalic artery in 42 cases among them(hybrid procedure). According to the relationship between the aorta and brachiocephalic artery， the thoracic aorta is divided into six areas:zone-1， zone 0， zone 1， zone 2， zone 3 and zone 4. According to the different position of dissection， Individualized endovascular repair was used. If aortic dissection was located in the ascending aorta or the descending aorta and the important branches were not involved（zone-1， zone3， zone4）， endovascular repair was used only. If the important branch of aorta were involved， the bypass established between aorta to brachiocephalic artery or brachiocephalic artery to brachiocephalic artery， and then endovascular repair was used. Results No death and severe complications occurred peri-operatively. Blood flows in stent grafts and bypass grafts were unobstructed. Endoleakage happened in 2 cases who received hybrid procedure. In another case， aortic intima ruptured again in distal stent graft 1 month after operation， and true lumen has been severely compressed. He recovered after another stent graft was implanted. All the other patients have good conditions with no obvious symptoms. All patients were followed up at 3 months and 1 year after operation. 20 patients lost to follow-up 1 year after operation. Conclusion　 ndivid