Short Term Clinical Efficacy of Endovascular Repair for Complicated Acute Type Stanford B Aortic Dissection in 36 Patients
10.3969/j.issn.1000-3614.2015.08.017
- VernacularTitle:腔内修复治疗36例复杂性急性Stanford B型主动脉夹层的短期临床疗效分析
- Author:
Jianghua ZHENG
;
Kai CHEN
;
Yanbin ZHU
;
Haifei WANG
;
Zhilong CHEN
;
Xi YONG
- Publication Type:Journal Article
- Keywords:
Complicated aortic dissection;
Endovascular repair
- From:
Chinese Circulation Journal
2015;(8):785-789
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To investigate the short term clinical efifcacy of endovascular repair for complicated acute type Stanford B aortic dissection.
Methods: To retrospectively analyze the clinical data of 36 patients with complicated acute type Stanford B aortic dissection who received endovascular repair in our hospital from 2010-01 to 2014-06 including operational procedure and post-operative follow-up of CT angiography. There were 27 male and 9 female patients with the average age of 43.7 years (41-62) years.
Results: Successful operations were conducted in all 36 patients. 22 patients received endovascular repair combined with covering left subclavian artery (LSA),10 received endovascular repair combined with chimney technique, 2 received endovascular repair combined with vascular prosthesis bypass from left common carotid artery to LSA, 2 received endovascular repair combined with vascular prosthesis bypass from right common carotid artery to left common carotid artery, whose proximal parts were ligated. Viscera artery and lower extremity artery supply were restored gradually. No complication of endoleak occurred. There 30/36 (83.33%) patients were followed-up for 1 year, and 10 patients developed thrombus in full false lumen and 20 developed thrombus in partial false lumen after 1 year. Compared with pre-operative values, thoracic aortic true lumen volume increased in either thrombus in full false lumen (190 ± 68.7) ml vs, (125.3 ± 63.4) ml and thrombus in partial false lumen (166.2 ± 71.8) ml vs (110.1 ± 62.7) ml,P<0.001; thoracic aortic false lumen volume decreased (65.0 ± 67.4) ml vs (185.3 ± 66.6) ml and (132.3 ± 62.6) ml vs (224.5 ± 72.3) ml,P<0.001. Compared with pre-operative values, for patients with thrombus in full false lumen, the abdominal aortic true lumen volume increased (55.5 ± 12.4) ml vs (48.6 ± 12.2) ml,P<0.01; for patients with thrombus in partial false lumen, the abdominal aortic false lumen volume also increased (58.2 ± 21.5) ml vs (42.5 ± 18.5) ml,P<0.01.
Conclusion: For endovascular repair of complicated aortic dissection, covering LSA with chimney technique and hybrid operation of small incision could extend anchor zone and expand the range of endovascular repair which may improve the effect and reduce the complication for good short term effect.
