中国胸心血管外科临床杂志

中国胸心血管外科临床杂志

三分支覆膜支架行主动脉弓重建治疗 Stanford A 型主动脉夹层效果的临床随访

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目的 通过长期随访采用三分支覆膜支架重建主动脉弓治疗 Stanford A 型主动脉夹层患者的临床治疗效果,评价三分支覆膜支架行主动脉弓重建安全性和可行性。 方法 选择从 2009 年 3 月至 2014 年 6 月在我院心脏大血管外科应用三分支覆膜支架治疗的 Stanford A 型主动脉夹层患者 17 例,其中男 11 例、女 6 例,年龄 35~72 岁。观查其临床疗效及并发症发生率以及术后 CT 随访结果。 结果 三分支主动脉弓覆膜支架治疗组患者随访期间死亡 1 例。术后不同随访时间 64 排 CT 血管造影结果显示支架血管位置满意,支架打开完全,无扭曲及内漏发生。主动脉各分支血管血流通畅,无狭窄及闭塞。3 个月后随访观察到有 8 例假腔血栓形成闭塞,6 个月后随访观察到所有患者假腔全部血栓闭塞。3 年后随访观察到支架稳定,未发生支架扭曲、变形或者断裂情况,假腔消失。 结论 三分支覆膜支架重建主动脉弓治疗 A 型主动脉夹层临床效果可靠,值得推广应用。

关键词: 主动脉夹层; Stanford A 型; 三分支覆膜支架; 手术

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