葛阳阳, 郭伟, 刘小平, 熊江, 贾鑫, 马晓辉, 张宏鹏, 崔豹. 胸主动脉腔内修复术治疗慢性B型主动脉夹层中期疗效分析[J]. 解放军医学院学报, 2015, 36(4): 337-341. DOI: 10.3969/j.issn.2095-5227.2015.04.010
引用本文: 葛阳阳, 郭伟, 刘小平, 熊江, 贾鑫, 马晓辉, 张宏鹏, 崔豹. 胸主动脉腔内修复术治疗慢性B型主动脉夹层中期疗效分析[J]. 解放军医学院学报, 2015, 36(4): 337-341. DOI: 10.3969/j.issn.2095-5227.2015.04.010
GE Yangyang, GUO Wei, LIU Xiaoping, XIONG Jiang, JIA Xin, MA Xiaohui, ZHANG Hongpeng, CUI Bao. Midterm outcome analysis of endovascular treatment for chronic type B aortic dissection[J]. ACADEMIC JOURNAL OF CHINESE PLA MEDICAL SCHOOL, 2015, 36(4): 337-341. DOI: 10.3969/j.issn.2095-5227.2015.04.010
Citation: GE Yangyang, GUO Wei, LIU Xiaoping, XIONG Jiang, JIA Xin, MA Xiaohui, ZHANG Hongpeng, CUI Bao. Midterm outcome analysis of endovascular treatment for chronic type B aortic dissection[J]. ACADEMIC JOURNAL OF CHINESE PLA MEDICAL SCHOOL, 2015, 36(4): 337-341. DOI: 10.3969/j.issn.2095-5227.2015.04.010

胸主动脉腔内修复术治疗慢性B型主动脉夹层中期疗效分析

Midterm outcome analysis of endovascular treatment for chronic type B aortic dissection

  • 摘要: 目的 评价慢性B型主动脉夹层(chronic type B aortic dissection,cTBD)行胸主动脉腔内修复术(thoracic endovascular aortic repair,TEVAR)的安全性和可行性。 方法 回顾性分析2011年1月-2013年12月本院行TEVAR的25例cTBD患者临床资料。根据随访结果和影像学资料评估患者临床转归和动脉重塑情况。 结果 手术成功率100%,术后30 d内无死亡病例,中位随访时间28.9(26.4 ~ 35.2)个月,1年生存率100%,2年和3年生存率均为95.2%(95%CI:86.1%~ 100%);支架覆盖动脉段动脉重塑较好,支架以远动脉段累积动脉扩张发生率30%~ 45%。 结论 TEVAR治疗cTBD的成功率和早、中期生存率高,但支架以远动脉重塑水平差。行TEVAR治疗的cTBD患者,术后需密切影像学随访。

     

    Abstract: Objective To assess midterm results of endovascular stent-graft placement for chronic type B aortic dissection (cTBD) and evaluate the safety and efficacy of TEVAR in cTBD patients. Methods Clinical data about 25 patients who were treated with stent-graft implantation for cTBD in our hospital from February 2011 to December 2013 were retrospectively analyzed. The clinical outcomes and arterial remodeling of patients were evaluated based on the follow-up and image data. Results The success rate was 100%, and no patients died within 30 days. Median follow-up time was 28.9 (26.4-35.2) months. The cumulative survival rate of 1 year and 3 years were 100% and 95.2%, respectively (95% CI:86.1%-100%). The aortic remodeling was good in the stents recovered segment, while the cumulative aortic enlargement incidence of aortic segment distal to stent-graft was 30%-45%. Conclusion TEVAR treatment for cTBD shows high technical success rate and high survival rate of early and middle age, but aortic remodeling of aortic segment distal to stent-graft performs bad. cTBD patients treated with TEVAR require close imaging follow-up.

     

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