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目的评价血管内支架置入治疗主动脉夹层动脉瘤的安全性和临床疗效。方法48例Stanford B型主动脉夹层动脉瘤患者行腔内修复术。所有患者在DSA下行左肱动脉穿刺插管、造影,了解主动脉真、假腔,夹层裂口及其与重要血管分支位置关系。腹股沟区纵切口显露股动脉,送入人工血管输送器至病变处,准确定位后,释放人工血管进行腔内修复。术后复查造影,观察真、假腔血液动力学变化,内脏及下肢动脉供血的改变。结果48例患者一次性成功置入人工血管支架,2例支架未能完全封堵漏口,内漏明显,手术成功率95.8%。支架置入后假腔血压下降,机体脏器缺血状况改善,临床症状好转或消失。结论支架性人工血管腔内修复术治疗主动脉夹层动脉瘤安全可行、效果明显,值得临床进一步推广。
Objective To evaluate the safety and clinical efficacy of intravascular stenting in the treatment of aortic dissection. Methods Forty-eight patients with Stanford type B aortic dissecting aneurysm underwent endovascular repair. All patients underwent left brachial artery puncture intubation in DSA, angiography, to understand the aortic true, false lumen, dissection and its relationship with the location of important vascular branches. The inguinal region longitudinal incision revealed the femoral artery, into the artificial vascular conveyor to the lesion, accurate positioning, the release of artificial blood vessels for endovascular repair. Postoperative contrast imaging, observed true and false lumen hemodynamic changes, visceral and lower extremity arterial blood supply changes. Results Forty-eight patients were successfully implanted with artificial stent. The stent failed to completely seal the leakage and the internal leakage was obvious. The success rate was 95.8%. Fistula lumen blood pressure decreased after stent placement, organ ischemia improved, clinical symptoms improved or disappeared. Conclusion Endovascular stent-graft repair of aortic dissection aneurysm safe and feasible, the effect is obvious, it is worth further clinical promotion.