CAJ | 학술논문

目的探讨腔内修复术治疗逆行撕裂的Stanford A型夹层的可行性.方法回顾性分析北京大学人民医院自2003年3月至2014年12月采用腔内修复术治疗的35例逆撕StanfordA型夹层的临床资料.男33例,女2例,年龄(46±9)岁.急性期29例,亚急性期2例,慢性期4例.夹层破口32例位于左锁骨下动脉以远,1例位于左锁骨下动脉与左颈总动脉之间,2例位于无名动脉与左颈总动脉之间.结果 35例患者均成功采用覆膜支架封堵夹层原发破口,Ⅰ型内漏3例(8.5％).围术期死亡患者2例(5.7％),1例(2.9％)发生一过性轻瘫,1例(2.9％)双烟囱患者术后第5天发生假腔供血肾动脉栓塞.随访31例(88.6％),随访时间l～107个月,平均(41±19)个月.随访期间所有患者主动脉重塑良好,升主动脉无新发破口,烟囱支架及弓部桥血管通畅.结论腔内修复术是逆撕Stanford A型夹层的一种安全、可靠的治疗方法.
목적 탐토강내수복술치료역행시렬적Stanford A형협층적가행성.방법 회고성분석북경대학인민의원자2003년3월지2014년12월채용강내수복술치료적35례역시StanfordA형협층적림상자료.남33례,녀2례,년령(46±9)세.급성기29례,아급성기2례,만성기4례.협층파구32례위우좌쇄골하동맥이원,1례위우좌쇄골하동맥여좌경총동맥지간,2례위우무명동맥여좌경총동맥지간.결과 35례환자균성공채용복막지가봉도협층원발파구,Ⅰ형내루3례(8.5％).위술기사망환자2례(5.7％),1례(2.9％)발생일과성경탄,1례(2.9％)쌍연창환자술후제5천발생가강공혈신동맥전새.수방31례(88.6％),수방시간l～107개월,평균(41±19)개월.수방기간소유환자주동맥중소량호,승주동맥무신발파구,연창지가급궁부교혈관통창.결론 강내수복술시역시Stanford A형협층적일충안전、가고적치료방법.
Objective To evaluate the feasibility of endovascular repair for retrograde type A aortic dissection.Method 35 patients of retrograde type A aortic dissection admitted to Peking University People's Hospital from December 2001 to March 2014 were treated with endovascular repair.There were 33 males and 2 females with mean age of 46 ± 9 years.29 were on acute stage,2 on subacute stage and 4 on chronic stage.The entry tear was in the descending thoracic aorta in 32 cases,between the left subclavian artery and the left common carotid artery in one,and between the left common carotid artery and the innominate artery in two.Results Entry closure was achieved in all patients with a covered stent.2 patients died in 30 days postoperatively (5.7％).1 patient with two chimney developed acute renal artery embolized which was infused by false lumin (2.9％).One patient developed transient paraparesis after graft deployment(2.9％).During the follow-up period,the aortic remodeling is perfect,no entry tear was noted in the ascending thoracic aorta.All the endografts for preserving supra-aortic branches were patent.Conclusions The endovascular repair for retrograde type A aortic dissection is feasible and effective.