腔内隔绝术治疗主动脉夹层及胸主动脉瘤.pdfVIP

2007 2 10 1 23 论著 a a a a b b 胡何节 , 邓福生 , 王晓天, 吴维 , 荚卫萍 , 历月琴 ( , a, b, 230001) [ ] 探讨腔内隔绝术治疗 DeBakey型主动脉夹层及胸主动脉瘤的手术时机及操作技巧 10例 DeBakey型主动脉夹层及胸主动脉瘤( DeBakey型主动脉夹层 9例胸主动脉瘤 1例)患者 腔内隔绝术, 术前 CTA 或MRA 及主动脉造影检查, 判断主动脉夹层裂口位置与数量及胸主动脉瘤范围左 锁骨下动脉开口左侧胸主动脉直径近端裂口至左锁骨下动脉开口的距离真腔直径以及腹主动脉主要分支 血管的血供来源, 选支架规格及输送路径, 然后在全麻下 右股动脉切开, 透视引导下置入支架释放系统, 定 位准确后释放覆膜支架, 完成腔内隔绝术1例因破裂口位于左颈总动脉与左锁骨下动脉之间而先 右颈总 动脉左颈总动脉左锁骨下动脉转流术 10例患者腔内隔绝术均获得成功近端裂口距左锁骨下动 脉开口距离平均 3. 5 cm, 出现型内漏 1例随访 1~ 2 个月, 术后无截瘫发生, 胸背部疼痛症状消失1例 胸主动脉瘤破裂伴食道瘘患者术后1 个月死于感染 腔内隔绝术治疗 DeBakey型主动脉夹层和胸 主动脉瘤是一种创伤小疗效确切的方法但远期效果仍有待进 一步观察 [ ] 主动脉疾病; 血管假体植入; 主动脉造影术 [ ] R5 3. 1 [ ] A [ ] 2007) Endovascular stentgrafts exclusion for the treamt ent of DeBakey type aortic dissections and thoracic aneu a a a a b b rysm H U H ej ie , DEN G Fusheng , WANG X iao tian , W U W ei , JIA W eip ing , LI Yueq ing (A nhui P ov incial H osp i tal, a. D ep a tm ent of Vascula Su g e y, b. D ep a tm ent of Radio logy, H ef ei 230001, China) [Abstract] Objective To assess the operative tmi ing and techn ique of endovascular graft exclus ion( EVGE) for DeBakey type thoracic aortic d issection and aneurysm. M ethods Ten patients ( 9 patientsw ith thoracic aortic d issection and 1w ith aneurysm ) underw ent EVGE. Preoperative com puted tom ography angiography( CTA ) orm agnet ic resonance angiography(MRA) and d igital subtraction angiography( DSA ) were performed to confirm the location and number of the d issecting tears and range of the aneurysm and m easure the diam eter of true lumen of the aorta both in the left side of left subclavian artery and descend ing part and the distance fro