CAJ | 학술논문

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。
목적：평개만성B형주동맥협층(chronic type B aortic dissection，cTBD)행흉주동맥강내수복술(thoracic endovascular aortic repair，TEVAR)적안전성화가행성。방법회고성분석2011년1월-2013년12월본원행TEVAR적25례cTBD환자림상자료。근거수방결과화영상학자료평고환자림상전귀화동맥중소정황。결과수술성공솔100%，술후30 d내무사망병례，중위수방시간28.9(26.4~35.2)개월，1년생존솔100%，2년화3년생존솔균위95.2%(95%CI：86.1%~100%)；지가복개동맥단동맥중소교호，지가이원동맥단루적동맥확장발생솔30%~45%。결론 TEVAR치료cTBD적성공솔화조、중기생존솔고，단지가이원동맥중소수평차。행TEVAR치료적cTBD환자，술후수밀절영상학수방。
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.