中国微创外科杂志
中國微創外科雜誌
중국미창외과잡지
CHINESE JOURNAL OF MINIMALLY INVASIVE SURGERY
2015年
2期
101-103
,共3页
蒋岚杉%王雪钢%白斗%武少辉%张效杰%夏氢%陈伟%尚建英%曾晓红
蔣嵐杉%王雪鋼%白鬥%武少輝%張效傑%夏氫%陳偉%尚建英%曾曉紅
장람삼%왕설강%백두%무소휘%장효걸%하경%진위%상건영%증효홍
胸主动脉夹层动脉瘤%导丝%输送轨道
胸主動脈夾層動脈瘤%導絲%輸送軌道
흉주동맥협층동맥류%도사%수송궤도
Thoracic aortic dissection%Guide wire%Track
目的：探讨腔内隔绝治疗Stanford B型胸主动脉夹层动脉瘤（ thoracic aortic dissection ，TAD）术中建立覆膜支架输送轨道的方法。方法对2005年10月～2013年9月行胸主动脉腔内修复术（ thoracic endovascular aortic repair ，TEVAR）治疗的Stanford B型TAD 81例进行回顾性分析。手术均在数字减影血管造影（ digital subtraction angiography ，DSA）监视下完成，术中使用进入真腔建立输送轨道的方法有导管沿途造影法45例、增强器切线位造影法16例、左肱动脉和股动脉导管双向造影法12例、导丝漂流上下贯通法8例。结果81例均成功进入真腔，覆膜支架成功隔绝夹层裂口。78例随访3～26个月，平均13．4月，无支架移位、血栓形成等并发症，2例出现Ⅱ型内漏。结论 TEVAR为确保导丝导管在真腔内，使支架准确放置真腔，可根据具体情况选择多种造影方法，建立有效的输送轨道。
目的：探討腔內隔絕治療Stanford B型胸主動脈夾層動脈瘤（ thoracic aortic dissection ，TAD）術中建立覆膜支架輸送軌道的方法。方法對2005年10月～2013年9月行胸主動脈腔內脩複術（ thoracic endovascular aortic repair ，TEVAR）治療的Stanford B型TAD 81例進行迴顧性分析。手術均在數字減影血管造影（ digital subtraction angiography ，DSA）鑑視下完成，術中使用進入真腔建立輸送軌道的方法有導管沿途造影法45例、增彊器切線位造影法16例、左肱動脈和股動脈導管雙嚮造影法12例、導絲漂流上下貫通法8例。結果81例均成功進入真腔，覆膜支架成功隔絕夾層裂口。78例隨訪3～26箇月，平均13．4月，無支架移位、血栓形成等併髮癥，2例齣現Ⅱ型內漏。結論 TEVAR為確保導絲導管在真腔內，使支架準確放置真腔，可根據具體情況選擇多種造影方法，建立有效的輸送軌道。
목적：탐토강내격절치료Stanford B형흉주동맥협층동맥류（ thoracic aortic dissection ，TAD）술중건립복막지가수송궤도적방법。방법대2005년10월～2013년9월행흉주동맥강내수복술（ thoracic endovascular aortic repair ，TEVAR）치료적Stanford B형TAD 81례진행회고성분석。수술균재수자감영혈관조영（ digital subtraction angiography ，DSA）감시하완성，술중사용진입진강건립수송궤도적방법유도관연도조영법45례、증강기절선위조영법16례、좌굉동맥화고동맥도관쌍향조영법12례、도사표류상하관통법8례。결과81례균성공진입진강，복막지가성공격절협층렬구。78례수방3～26개월，평균13．4월，무지가이위、혈전형성등병발증，2례출현Ⅱ형내루。결론 TEVAR위학보도사도관재진강내，사지가준학방치진강，가근거구체정황선택다충조영방법，건립유효적수송궤도。
Objective To investigate methods of establishing track delivery in the endovascular treatment of Stanford B type thoracic aortic dissection (TAD). Methods From October 2005 to September 2013, 81 cases of Stanford B type TAD were treated . Operations were performed under digital subtraction angiography ( DSA ) guidance .Intraoperatively , methods of establishing track delivery included “along the way” catheter angiography (45 cases), enhanced tangential angiography (16 cases), the left brachial artery and femoral artery two-way catheter angiography (12 cases), and guide wire drifting through up and down (8 cases). Results The catheter was successfully entered the true lumen in all the 81 cases.The interlayer gap was successfully isolated by stents . Seventy-eight cases were followed up for 3 -26 months ( mean, 13.4 months ).No stent migration, thrombosis, and other complications occurred .There were 2 cases of type Ⅱ endoleak . Conclusion To ensure the guide wire or catheter and stent entering the true lumen in thoracic endovascular aortic repair , effective delivery track can be established by a variety of imaging methods depending on patients ’ conditions .
