Objevtive To observe the therapeutic effect of endovascular aortic repair(EVAR) in the treatment of Stanford B aortic dissection and aortic aneurysm. Methods From January 2014 to June 2008, 45 patients with Stanford B aortic dissection were retrospectively analyzed , a total of 39 cases with EVAR , including 33 male and 6 female, aged 42-80 (54.3 ±8.3) years. CT angiography was performed in all patients before operation. 5 cases received local anesthesia, 34 cases underwent general anesthesia, and the stent was placed under the digital subtraction angiography. Results 39 patients were operated successfully. Among them, two cases of pulmonary infection and pleural effusion were cured after anti-infective therapy, one case of CTA left kidney shows significant improvement in development, one case of paraplegia, and other 35 patients with better clinical recovery. 36 cases were followed up for 3 months, follow-up rate was 94.7%. All the patients were followed up with stable blood pressure, and the true lumen diameter of the stent was recovered, and the false lumen or tumor cavity was formed. Conclusion EVAR provides a safe and effective method for the treatment of Stanford B aortic dissection, especially for the elderly and patients with severe disease, which provides a new method of treatment, with obvious advantages, worthy of clinical application.%目的 观察覆膜支架腔内修复术(endovascular aortic repair, EVAR)对Stanford B型主动脉夹层和降主动脉瘤的治疗效果.方法 回顾性分析2008年1月至2014年6月收治的45例Stanford B 型主动脉夹层患者的临床资料,共39例行EVAR,其中男33例,女6例;年龄42~80(54.3±8.3)岁,分析其疗效.所有患者术前均行CT血管造影检查.5例患者行局部麻醉,34例行全身麻醉,均在数字减影血管造影下置入覆膜支架完成腔内修复术.结果 39例患者均手术成功.其中,2例肺部感染并胸腔积液患者经抗感染治疗后痊愈,1例CTA示左肾显影明显改善,1例出现截瘫,另35例患者术后临床恢复较好.随访满3个月者36例,随访率94.7%.全部随访患者血压稳定,支架范围内真腔管径有所恢复,假腔或瘤腔内血栓形成.结论 EVAR为治疗Stanford B型主动脉夹层动脉瘤提供了一个安全有效的方法,特别是为高龄和合并严重疾病的患者提供了新的治疗手段,优势明显,值得临床应用.
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