锥形覆膜支架治疗主动脉夹层动脉瘤疗效剖析.docVIP

锥形覆膜支架治疗主动脉夹层动脉瘤疗效剖析 　　[摘要] 目的 探讨锥形覆膜支架治疗主动脉夹层动脉瘤的疗效。 方法 于2012年2月―2013年6月间，随机选择60例真腔狭小的Stanford B型主动脉夹层患者，选用国产锥形覆膜支架系统进行腔内隔绝术并观察其疗效。 结果 技术成功率即支架植入成功率为100%，60例患者的第一破口完全封闭。术中出现轻度近端I型内漏12例（20%），未做处理，在3个月随访中自愈。术后反复胸痛3例，服用止痛药缓解，持续约6个月，其余患者术后即刻症状消失，内脏缺血症状改善。经随访，60例患者均存活，未发现远端逆撕破口，支架形态良好，假腔内大部分血栓形成，真腔逐步扩大。 结论 国产锥形覆膜支架系统减少了对远端内膜的损伤，尤其适用于真腔狭小的胸主动脉夹层病人，临床效果证明是安全、有效的，值得推广。 　　[关键词] 锥形覆膜支架；主动脉夹层动脉瘤 　　[中图分类号] R4 [文献标识码] A [文章编号] 1674-0742（2015）02（b）-0104-03 　　A single-center’s experience on clinical applyment of tapered design stent-graft in the treatment of aortic dissection 　　XIONG Jianming 　　Department of vascular and endovascular surgery， YiYang Central Hospital， Hunan Province， 413000 China 　　[Abstract] Objective To evaluate the clinical result of applyment of tapered design stent-graft in the treatment of aortic dissection. Methods Random select 60 cases of Type B Aortic dissection with narrow true lumen using domestic tapered design stent-graft from February 2012 to June 2013. Results Technical success rate of stent implantation is the success rate was 100%， 60 cases of patients with first break were completely closed. A mild proximal type I endoleak was 12 cases （20%）， untreated， self healing at three months follow-up. Repeated postoperative chest pain in 3 cases， taking pain killers， lasted about 6 months， the symptoms disappeared in the rest of the patients immediately after the operation， visceral ischemia symptoms improve. During follow-up， 60 patients were alive， distal inverse tear break were not founded， the stent has good appearance， false lumen most of thrombosis， the true lumen gradually expand. Conclusions Domestic tapered design stent-graft can reduce the injury to the distal intimal layer which is especially suit for the patients with narrow true lumen. The results are safe and effective. 　　[Key words] Tapered design stent-graft； Aortic dissection 　　主动脉夹层是指在主动脉内膜发生破裂的作用下，高速血流通过内膜破口，进入主动脉壁中层，使主动脉壁分离撕裂为真、假两腔[1]。在主动脉夹层分型方法中，Stanford分型是最为广泛应用的分型方法。Stanf