Endovascular stent graft repair of aortic dissection type B extending to the aortic arch.
Endovascular stent graft repair of aortic dissection type B extending to the aortic arch.
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DOI：
10.1016/j.ejvs.2011.06.050
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发表时间：
2011-10
期刊：
影响因子：
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通讯作者：
Q. Lu;Z. Jing;Zhiqing Zhao;J. Bao;Xiang Feng;R. Feng;Z. Mei
中科院分区：
文献类型：
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作者：
Q. Lu;Z. Jing;Zhiqing Zhao;J. Bao;Xiang Feng;R. Feng;Z. Mei
分析我们的经验，血管内覆膜支架修复降主动脉夹层，需要主动脉上分支血管血运重建。回顾性研究。方法从2001年至2009年，22例连续与上述夹层进行了回顾性分析。入选要求：左锁骨下动脉近端的主动脉锚定区小于15 mm。根据夹层特征选择混合型、扇形或开孔型血管内覆膜支架。年度随访访视（中位数27.1个月）包括计算机断层扫描血管造影。终点包括进行性病理、并发症和生存率。除一例手术并发症外，所有患者均获得成功。两名患者在手术后30天内死亡，一名死于脑梗死，另一名死于心肌梗死。其余患者无术后并发症发生。所有患者的移植物隔绝段的主动脉假腔内均形成血栓。18例患者的该段最大直径减小，2例稳定。在19例患者中，血流仍然存在于未被支架覆盖的隔绝区远端的假腔内。在中期和长期随访中观察到通畅性，没有近端内漏，移植物移位或deaths.CONCLUSIONEndovascular覆膜支架方法显示出在涉及远端弓的近端降主动脉夹层的血管内覆膜支架修复中的前景。
OBJECTIVETo analyse our experience with endovascular stent graft repair of descending aorta dissections that require supraaortic branch vessel revascularisation.DESIGNRetrospective study.METHODSFrom 2001 to 2009, 22 consecutive patients with the above dissections were retrospectively analysed. Inclusion requirement: aortic landing zone proximal to the left subclavian artery of less than 15 mm. Hybrid, scalloped or fenestrated endovascular stent grafts were selected based on dissection characteristics. Annual follow-up visits (median 27.1 months) included computed tomography angiography. End points include progressive pathology, complications and survival rates.RESULTSSurgery was successful in all except for one operative complication. Two patients died within 30 days after surgery, one to cerebral infarction and the other to myocardial infarction. No postoperative complications occurred in the remaining patients. Thrombosis formed in the aortic false lumen of the graft exclusion segment in all patients. The maximum diameter of this segment decreased in 18 patients and was stable in two. In 19 patients, blood flow remained in the false lumen distal to the exclusion area not covered by stent. Patency was seen at mid- and long-term follow-up, without proximal endoleak, graft displacement or deaths.CONCLUSIONEndovascular stent graft methods show promise in endovascular stent graft repair of proximal descending aortic dissections involving the distal arch.