[1]夏金国,施海彬,杨正强,等.Stanford B型主动脉夹层多型支架介入治疗的临床体会[J].介入放射学杂志,2010,(05):369.
　XIA Jinguo,SHI Haibin,YANG Zhengqiang,et al.Endovascular repair of Stanford B type aortic dissection by using different kinds of stents：clinical experience[J].journal interventional radiology,2010,(05):369.
点击复制

Stanford B型主动脉夹层多型支架介入治疗的临床体会()

PDF下载中关闭

分享到：

《介入放射学杂志》[ISSN:1008-794X/CN:31-1796/R]

卷:
期数:
2010年05期
页码:
369
栏目:
血管介入
出版日期:
2010-05-15

文章信息/Info

Title:
Endovascular repair of Stanford B type aortic dissection by using different kinds of stents：clinical experience
作者:
夏金国; 施海彬; 杨正强; 等
２１００２９南京医科大学第一附属医院介入放射科
Author(s):
XIA Jin－guo; SHI Hai－bin; YANG Zheng－qiang; LIU Sheng; ZHOU Chun－gao; ZHAO Lin－bo; LI Lin－sun
the First Affiliated Hospital of Nanjing Medical University，Nanjing２１００２９，China
关键词:
主动脉夹层; 支架; 腔内修复; 适应证
分类号:
R５４３.５
摘要:
目的应用多种类型支架行Stanford B型主动脉夹层介入治疗，探讨扩大介入治疗适应证的可行性。方法回顾性分析２００４年５月－２００９年１２月，１８例Stanford B型主动脉夹层患者行介入性腔内修复术治疗的临床资料。根据CTA和DSA结果，个体化选择合适覆膜支架，透视下将覆膜支架经股动脉导入封闭夹层破口。术后CTA随访观察内漏、支架移位、假腔变化等。结果１８例中２例放置分体式主动脉覆膜支架、１例放置分支型覆膜支架、２例放置预留孔型主动脉覆膜支架，１３例放置普通主动脉覆膜支架。１例封堵左锁骨下动脉、２例不全封堵左锁骨下动脉均未出现左上肢和椎基底动脉缺血症状；１例因解剖变异右锁骨下动脉起自主动脉弓而行旁路手术。术后发生８例（４４．４％）即刻I型内漏，其中１例腔内修复术后持续I型内漏再次放置支架后进展为Standford A型主动脉夹层瘤而行升主动脉人工血管置换术，其余CTA随访内漏逐渐消失；所有患者均无支架移位、断裂、塌陷以及术后截瘫及脑血管意外发生。结论采取不同方法延长近端锚定区的距离、应用分体式主动脉支架可扩大介入治疗Standford B型主动脉夹层的适应证，且近期疗效好，中、远期疗效有待进一步观察。

参考文献/References:

［１］Holger E，Christoph AN，Markus NR，et al．Endovascular stent－graft placement in aortic dissection：a meta－analysis［J］．J Eur Heart，２００６，２７：４８９－４９８．
［２］Rehders TC，Petzsch M，Ince H，et al．Intentional occlusion of the left subclavian artery during stent－graft implantation in the thoracic aorta：risk and relevance［J］．J Vasc Surg，２００４，１１：６５９－６６６．
［３］Brain GP，Mark KE，Thomas GG，et al．Utility of left subclavian artery revascularization in association with endoluminal repair of acute and chronic thoracic aortic pathology［J］．J Vasc Surg，２００６，４３：４３３－４３９．
［４］尤庆生，严煜，刘琨，等．主动脉夹层瘤诊断和治疗方法的选择［J］．中国临床医学，２００６，１３：３５９－３６１．
［５］董智慧，符伟国，王玉琦，等．胸主动脉腔内修复扩展近端锚定区的探讨［J］．中华外科杂志，２００５，４３：８５７－８６０．
［６］李潮，李玉亮，汪忠镐，等．分支型腔内支架人工血管治疗B型主动脉夹层［J］．中华胸心血管外科杂志，２００６，２２：１５２－１５４．
［７］Bleyn J，Schol F，Vanhandenhove I，et al．Side－branched modular endograft system for thoracoabdominal aortic aneurysm repair［J］．J Endovasc Ther，２００２，９：８３８－８４１．
［８］Kang SG，Lee DY，Munehiro M，et al．Aortic dissection：percutaneous management with a separating stent－graft－preliminary results［J］．Radiology，２００１，２２０：５３３－５３９．
［９］李麟荪，施海彬，张石江，等．分体式覆膜支架治疗主动脉病变的初步报告［J］．中华放射学杂志，２００５，３９：９１７－９２０．
［１０］Won JY，Lee DY，Shim WH，et al．Elective endovascular treatment of descending thoracic aortic aneurysms and chronic dissections with stent－graft［J］．J Vasc Interv Radiol，２００１，１２：５７５－５８２．

相似文献/References:

[1]张鑫 刘建民 洪波 许奕 黄清海 张珑 赵文元 周晓平.多支架治疗颅内外动脉狭窄[J].介入放射学杂志,2003,(03):198.
[2]秦永林,邓钢,郭金和,等.长球囊治疗重症下肢动脉缺血性病变的近期疗效观察[J].介入放射学杂志,2008,(05):323.
　QIN Yonglin,DENG Gang,GUO Jinhe,et al.Short term evoluation of the percutaneous transluminal angioplasty with long balloon for the treatment of critical limb ischemia[J].journal interventional radiology,2008,(05):323.
[3]沈杰,王成刚,马爱英,等.内支架置入对不同类型下腔静脉恶性梗阻的临床价值[J].介入放射学杂志,2008,(07):493.
　SHEN Jie,WANG Chenggang,MA Aiying,et al.Clinical evaluation of stenting for different types of malignant inferior vena cava obstruction[J].journal interventional radiology,2008,(05):493.
[4]李钊硕,李天晓,翟水亭,等.症状性颅内动脉粥样硬化性狭窄的Wingspan支架成形术[J].介入放射学杂志,2008,(08):555.
　LI Zhaoshuo,LI Tianxiao,ZHAI Shuiting,et al.Treatment of symptomatic intracranial atheromatous ischemic disease with Wingspan stent system：short－term results[J].journal interventional radiology,2008,(05):555.
[5]李郁芳,蒋初明,李冬华,等.金属裸支架与药物洗脱支架在治疗症状性椎－基底动脉狭窄与急性闭塞中的应用[J].介入放射学杂志,2008,(10):692.
　LI Yufang,JIANG Chuming,LI Donghua,et al.Preliminary clinical application of bare metal stent and drug eluting stent angioplasty in vertebrobasilar stenosis and acute occlusion[J].journal interventional radiology,2008,(05):692.
[6]刘令强,张之营,缪中荣,等.复杂性椎－基底动脉重度狭窄介入治疗临床分析[J].介入放射学杂志,2008,(11):809.
　LIU Lingqiang,ZHANG Zhiying,MIAO Zhongrong,et al.Clinical evaluation of interventional treatment of severe complicated stenosis of vertebrobasilar system[J].journal interventional radiology,2008,(05):809.
[7]周兵,方淳,李明华,等.颅内微小动脉瘤的介入弹簧圈栓塞治疗及中期随访观察[J].介入放射学杂志,2008,(12):845.
　ZHOU Bing,FANG Chun,LI Minghua,et al.Interventional coil embolization for micro－intracranial aneurysms and the midterm follow－up[J].journal interventional radiology,2008,(05):845.
[8]刘娟,姚国恩,蒋晓江,等.彩色多普勒超声定位下压迫治疗介入后股动静脉瘘一例[J].介入放射学杂志,2008,(12):908.
　LIU Juan,YAO Guoen,JIANG Xiaojiang,et al.Color Doppler ultrasound guided compression for treatment of interventional femoral arteriovenous fistula：a case report[J].journal interventional radiology,2008,(05):908.
[9]赵剑波,曾庆乐,陈勇,等.食管支架术后支架贴壁不良综合征的初步探讨[J].介入放射学杂志,2010,(02):141.
　ZHAO Jianbo,ZENG Qingle,CHEN Yong,et al.Preliminary investigation of esophageal stent dys－seal syndrome[J].journal interventional radiology,2010,(05):141.
[10]黄海东,赵凯,顾建文,等.新型颅内支架Enterprise结合水解脱弹簧圈栓塞治疗颅内微小宽颈动脉瘤[J].介入放射学杂志,2010,(02):91.
　HUANG Haidong,ZHAO Kai,GU Jianwen,et al.A novel intracranial Enterprise stent together with coils for the treatment of very small intracranial wide－necked aneurysms[J].journal interventional radiology,2010,(05):91.

备注/Memo

备注/Memo:
收稿日期：２０１０－０３－０１
基金项目：江苏省科技厅社会发展计划资助项目（BS２００６０７９）、国家十一·五支撑计划子课题（２００６０３８０７３０２４）
更新日期/Last Update: 2010-05-15