Chimney stent in acute Stanford type B aortic dissection with insufficient anchorage zone
10.3760/cma.j.cn113855-20210314-00162
- VernacularTitle:“烟囱”支架在急性期锚定区不足的Stanford B型主动脉夹层中的应用体会
- Author:
Songwei CHEN
1
;
Shaomang LIN
;
Zhihui ZHANG
;
Jianbin XIAO
;
Qiang LI
;
Wenjia AI
;
Yangyong LI
Author Information
1. 广州医科大学附属第二医院血管外科，广州 510260
- Keywords:
Aortic diseases;
Vascular surgical procedures;
Endoleak;
Chimney technique
- From:
Chinese Journal of General Surgery
2022;37(2):113-117
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the effect of chimney stent for reconstruction of left subclavical artery (LSA) in thoracic endovascular aotic repair (TEVAR) for acute Stanford type B aortic dissection with insufficient anchorage zone and non-thrombotic false lumen.Methods:TEVAR with chimney stent for LSA in 39 cases of acute Stanford type B aortic dissection with insufficient anchorage zone and non-thrombotic false lumen was done from Feb 2013 to Jan 2021.Results:Covered chimney stents was used in 11 cases and bare chimney stents in 28 cases. There was no postoperative stroke, left upper limb ischemia, paraplegia, hemiplegia and death. No stent migration, reverse tear and dissection rupture were observed. One bare stent was obstructed after 18 months, and all the remaining stents were patent during follow-up. The rate of immediate type Ⅰa endoleak in covered chimney stent group and bare chimney stent group were 0(0/11) and 32.1%(9/28) respectively ( P=0.04). The distance from proximal tear to LSA in covered chimney stent group, endoleak subgroup and non-endoleak subgroup in bare chimney stent were (5.1±2.3)mm, (14.4±5.2)mm and (7.8±7.0)mm respectively ( P<0.05). False lumen thrombosis was formed in endoleak subgroup 2-8 weeks after operation, and endoleak disappeared. Conclusions:There is a correlation between immediate type Ⅰa endoleak in bare chimney stent for LSA and the distance from proximal tear to LSA, covered chimney stent can reduce the incidence of immediate type Ⅰa endoleak in TEVAR for acute Stanford type B aortic dissection with insufficient anchorage zone and non-thrombotic false lumen.
