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魏立春a,张玉霞b,侯培勇a,李祺熠a,郑志勇a,苏奕明a,郑 毅a,张 科a,罗长志a,许太福a,叶奕辉a,蓝宇俭a,韦肖敏a
Abstract:
Therapeutic effect of situ fenestration by laser in intracavitary with stent covered a membrane implantation in the treatment of Stanford type A aortic dissection(aneurysm) WEI Li-chun*,ZHANG Yu-xia,,HOU Pei-yong,et al.Department of Vascular Surgery, Liuzhou Worker's Hospital, Liuzhou 545005,China Corresponding author:HOU Pei-yong, E-mail:zxp19841223@126.com Abstract Objective To investigate the short-term efficacy of aortic arch repair in combination with situ fenestration by laser in intracavitary with stent covered a membrane implantation in the treatment of Stanford type A aortic dissection(aneurysm). Methods Seven cases of Stanford type A aortic dissection(aneurysm)were treated with vivo repair of lumbar stent by laser in situ windowing technique in Liuzhou Worker's Hospital from November 2016 to May 2017. The 7 cases included 4 cases of intraoperative brachiocephalic trunk and left common carotid artery and left subclavian artery fenestration,2 cases of brachiocephalic trunk and left common carotid artery fenestration,1 case of left common carotid artery and left subclavian artery fenestration. Acute surgery was performed in 5 cases and chronic surgery in 2 cases. Results Thirteen conical aortic stent and fluency plus straight stent grafts were implanted in all the cases. There was one case (14.3%) died of intraoperative ascending aorta rupture and the incidence of early postoperative complications was 28.6%. All the cases were cured and discharged through treatment.The whole results of one month and three months follow-up showed the rupture of dissection (aneurysm) isolated, no endoleak, window smoothing . Conclusion Aortic arch internal fixation combined with intraocular laser in situ stent implantation is safe and effective in the treatment of Stanford type A aortic dissection(aneurysm). It has the following advantages of less trauma, quick recovery, high intraoperative success rate, low incidence of endoleak, which has good recent results. However,long-term efficacy still need further follow-up to confirm.
Key words: aneurysm, dissection, cardiopulraonary bypass, endovascular repair, fenestration in situ
摘要:
目的 探讨主动脉弓腔内修复术联合体内激光原位开窗覆膜支架植入术治疗Stanford A型主动脉夹层的近期疗效。方法 2016年11月至2017年5月柳州市工人医院血管外科对7例Stanford A型主动脉夹层病人应用体内激光原位开窗技术进行覆膜支架腔内修复术。术中头臂干+左颈总动脉+左锁骨下动脉开窗4例,头臂干+左颈总动脉开窗2例,左颈总动脉+左锁骨下动脉开窗1例。急性期手术5例,慢性期手术2例。结果 7例病人植入锥形大动脉支架13枚、Fluency plus直管型覆膜支架18枚。术中因升主动脉破裂死亡1例(14.3%),术后早期并发症发生率为28.6%,所有病人经治疗后均痊愈出院。术后1个月、3个月随访结果均显示夹层破口隔绝良好,无内漏,开窗血管通畅。结论 主动脉弓腔内修复术联合体内激光原位开窗覆膜支架植入术治疗Stanford A型主动脉夹层安全、有效,且创伤小、恢复快、术中成功率高、内漏发生率低,近期效果良好,中、远期疗效尚需随访进一步证实。
关键词: 动脉瘤, 夹层, 体外转流, 腔内修复, 原位开窗
魏立春a,张玉霞b,侯培勇a,李祺熠a,郑志勇a,苏奕明a,郑 毅a,张 科a,罗长志a,许太福a,叶奕辉a,蓝宇俭a,韦肖敏a. 腔内激光原位开窗覆膜支架植入术治疗Stanford A型主动脉夹层7例疗效分析[J]. 中国实用外科杂志, DOI: 10.19538/j.cjps.issn1005-2208.2017.12.18.
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URL: https://www.zgsyz.com/zgsywk/EN/10.19538/j.cjps.issn1005-2208.2017.12.18
https://www.zgsyz.com/zgsywk/EN/Y2017/V37/I12/1385