中国普通外科杂志2017，Vol.26Issue(12)：1541-1546,6.DOI:10.3978/j.issn.1005-6947.2017.12.006
杂交或腔内修复术治疗B型主动脉夹层合并迷走锁骨下动脉伴Kommerell憩室的疗效分析
Efficacy analysis of hybrid procedures or endovascular repair for type B aortic dissection with aberrant subclavian artery and Kommerell's diverticulum
摘要
Abstract
Objective: To investigate the efficacy of hybrid procedures or endovascular repair for type B aortic dissection concomitant with aberrant subclavian artery and Kommerell's diverticulum. Methods: The clinical data of 5 patients with type B aortic dissection complicated by aberrant subclavian artery and Kommerell's diverticulum treated from January 2013 to December 2016 were retrospectively analyzed. The patterns of aortic arch variations, the location of the proximal tear and surgical options as well as the perioperative and follow-up results of the patients were summarized.Results: According to the patterns of aortic arch variations and location of the proximal tear of the patients, 2 cases underwent hybrid surgery and 3 cases underwent endovascular aortic repair alone. The operative time ranged from 90 to 538 min, with an average of 294 min. Postoperative immediate angiography showed the completely occluded tears, and normal blood flow in the branches of the aortic arch or bypass grafts. One patient died of massive cerebellar infarction on one week after operation but the other 4 patients were alive during postoperative follow-up period, and no symptoms of brain or upper limb ischemia were noted and no stent displacement or endoleak occurred. Conclusion: The variations of aortic arch branches along with the vascular frangibility of the Kommerell's diverticulum cause surgical inconvenience. Hybrid surgery or endovascular repair is feasible in treatment of aortic dissection concomitant with aberrant subclavian artery and Kommerell's diverticulum. However, the treatment experience for this condition should be further enhanced, and the long-term efficacy remains to be determined.关键词
动脉瘤,夹层/主动脉,胸/血管畸形/锁骨下动脉/解剖变异Key words
Aneurysm/Dissecting/Aorta/Thoracic/Vascular Malformations/Subclavian Artery/Anatomic Variation分类
医药卫生引用本文复制引用
承文龙,原野,卢辉俊..杂交或腔内修复术治疗B型主动脉夹层合并迷走锁骨下动脉伴Kommerell憩室的疗效分析[J].中国普通外科杂志,2017,26(12):1541-1546,6.基金项目
国家自然科学基金资助项目(81572783). （81572783）
