广州医科大学学报

目的:探讨腔内隔绝术治疗胸主动脉夹层的适应证选择和疗效。方法: 2002年8月至2004年11月我院住院的4例(年龄48~82岁;男3例,女1例)胸主动脉夹层患者行腔内隔绝术,并进行临床分析和随访,评价其临床效果。结果:在全麻下4例均成功在胸主动脉夹层的血管腔内释放覆膜支架,其中为StandfordA型及StandfordB型各2例,共使用Talent覆膜血管支架4个,术中造影证实StandfordB型夹层裂口完全封闭,无术中严重并发症及死亡发生, StandfordA型1例术后证实内漏存在,术后3d死亡, 1例在支架释放后出现左冠脉急性闭塞致死亡。结论:应用覆膜血管内支架行腔内隔绝术(EVGE)是治疗StandfordB型胸主动脉夹层安全有效的方法。StandfordA型夹层行EVGE术仍有待进一步对技术及器械进行改良。

Objective:To investigate the surgical indication and therapeutic effect in treating Standford A and B aortic dissection using endovascular graft exclusion(EVGE).Methods: Four patients with thoracic aortic dissection(2 with Standford A and others with Standford B)who underwent procedure of mini-traumatic EVGE from August 2002 to November 2004 were analyzed.Tubular graft stents were introduced over the entry tear of aorta via the femoral artery.Results: The procedure was technically successful in all patients.There were no severe complications occurred during the perioperative period and two standford B patients survived over 3-27 months’ follow-up. Conclusion: EVGE is safe and effective for Standford B aortic dissection and can be the first choice for treating these patients.But it may need some technical improvement as to be used for Standford A.