朱亮,朱永宏

• 1:广东东莞康华医院心内一科

摘要(Abstract)：

<正>主动脉夹层(aortic dissection,AD)是指各种外因(如高血压病、外伤等)伴或不伴自身血管病变的综合作用导致主动脉内膜破裂,血液从内膜撕裂口进入主动脉壁中层,造成主动脉中层沿纵轴顺行、逆行或双向逐渐延伸扩展形成血肿,从而使主动脉管壁出现真假腔的一种临床少见而凶险的大血管急症[1-2]。目前DeB akeyⅢ型AD多采用腔内隔绝术(thoracic endovascular aortic repair,TEVAR)治疗。

关键词(KeyWords)： 主动脉夹层;腔内隔绝术;超声血管造影;主动脉重塑

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 朱亮,朱永宏

参考文献(References)：

• [1]孙立忠.主动脉外科学.北京:人民卫生出版社,2012:392-393.
• [2]景在平,冯翔.主动脉夹层腔内隔绝术.北京:人民军医出版社,2008:13.
• [3]王巍,王康,杨岷,等.68例主动脉夹层外科治疗体会.临床外科杂志,2014,22(7):483-486.
• [4]Lu Q,Jing Z,Zhao Z,et al.Endovascular stent graft repair of aortic dissection type B extending to the aortic arch.Eur J Vasc Endovasc Surg,2011,42(4):456-463.
• [5]Cyrus J,Judson B,Syamal D,et al.Midterm results with thoracic endovascular aortic repair for chronic type B aortic dissection with associated aneurysm.J Thorac Cardiov Surg,2011,141(2):322-327.
• [6]Eggebrecht H,Nienaber CA,Neuhuser M,et al.Endovascular stent-graft placement in aortic dissection:a meta-analysis.Eur Heart J,2006,27(4):489-498.
• [7]Dong Z,Fu W,Wang Y,et al.Stent graft-induced new entry after endovascular repair for Stanford type B aortic dissection.J Vasc Surg,2010,52(6):1450-1457.
• [8]Nienaber CA,Rousseau H,Eggebrechth,et al.Randomized comparison of strategies for type B aortic dissection:the investigation of stent grafts in aortic dissection(instead)trial.Circulation,2009,120(25):2519-2528.
• [9]杜昕,郭伟,刘小平,等.腹主动脉瘤患者腔内修复术后Ⅱ型内漏的处理分析.中华医学杂志,2011,91(42):2955-2957.
• [10]周妙,朱永宏,朱遵平,等.De BakeyⅢ型主动脉夹层腔内隔绝术后近端Ⅰ型内漏的影响因素分析.岭南心血管病杂志,2014,20(6):729-733.
• [11]Karabuht H,Senay S,Toramaa F,et al.Treatment of delayed retrograde dissection after endovascular stenting of thoracoabdominal aortic aneurysm:graft-to-endograft anastomosis.Heart Surg Forum,2009,12(1):61-62.
• [12]Pua U,Tay KH,Tan BS,et al.CT appearance of complications related to thoracic endovascular aortic repair(TEVAR):a pictorial essay.Eur Radiol,2009,19(5):1062-1068.
• [13]Amabile P,Grisoli D,Giorgi R,et al.Incidence and determinants of spinal cord ischaemia in stent-graft repair of the thoracic aorta.Eur J Vasc Endovasc Surg,2008,35(4):455-461.
• [14]韩向军,徐克.B型主动脉夹层腔内修复治疗的荟萃分析.介入放射学杂志,2011,20(7):530-533.
• [15]汪忠镐,金炜,李鸣,等.微创外科治疗大动脉疾病.中华胸心血管外科杂志,2003,19(6):332-324.
• [16]Coady MA,Ikonomidis JS,Cheung AT,et al.Surgical management of descending thoracic aortic disease:open and endovascular approaches:a scientific statement from the American.Circulation,2010,121(25):2780-2804.
• [17]Tsai TT,Evangelista A,Nienaber CA,et al.Partial thrombosis of the false lumen in patients with acute type B aortic dissection.N Engl J Med,2007,357(4):349-359.
• [18]Feng J,Lu Q,Zhao Z,et al.Restrictive Bare stent for Prevention of stent Graft-induced distal redissection after thoracic endovascular aortic repair for type B aortic dissection.J Vasc Surg,2013,57(Suppl 2):S44-S52.
• [19]Lombardi JV,Cambria RP,Nienaber CA,et al.Prospective multicenter clinical trial(STABLE)on the endovascular treatment of complicated type B aortic dissection using a composite device design.J Vasc Surg,2012,55(3):629-640.
• [20]张本青,赵振华,叶蕴清,等.De BakeyⅢ型主动脉夹层及其覆膜支架腔内隔绝术.中国现代普通外科进展,2010,13(10):809-811.
• [21]Brown KE,Eskandari MK,Mathumura JS,et al.Short and midterm Results with minimally invasive endovascular repair of acute and chronic thoracic aortic pathology.J Vasc Surg,2008,47(4):714-722.
• [22]景在平,陆清声,冯家烜,等.主动脉夹层腔内隔绝术后并发症.中国血管外科杂志电子版,2012,4(4):196-199.
• [23]Scali ST,Beck AW,Butler K,et al.Pathology specific secondary aortic interventions after thoracic endovascular aortic repair.J Vasc Surg,2014,59(3):599-607.
• [24]李向荣,李荣富,周宏,等.层螺旋在主动脉夹层支架植入术前及术后的应用与评价.中国临床医学影像杂志,2010,24(7):514-516.
• [25]徐忠伟,刘晓馨,刘昱.16层螺旋CTA在主动脉夹层动脉瘤的临床应用价值.中国现代医生,2010,22(32):205-210.
• [26]印隆林,杨志刚,陈加源,等.多层螺旋血管成像在主动脉夹层诊断中的临床价值.放射学实践,2012,27(4):406-410.
• [27]田家玮,任卫东.超声科主治医生450问.2版..北京:中国协和医科大学出版社,2011,2(6):146-149.
• [28]Jánosi RA,Erbel R,Konorza TF.Recent advances in the diagnosis of acute aortic syndromes.Expert Opin Med Diagn,2012,6(6):529-540.
• [29]秋阳,李治安,崔复霞,等.彩色多普勒超声在腹主动脉瘤破裂诊断中的应用价值.中华老年心脑血管病杂志,2012,14(6):606-608.
• [30]王多丽.彩色多普勒超声诊断主动脉夹层17例.世界最新医学信息文摘(电子版),2014,10(8):134-134.
• [31]王金花.彩色多普勒超声对主动脉夹层动脉瘤的诊断价值.基层医学论坛,2013,10(8):1013-1014.
• [32]申淑霞.彩色多普勒超声在主动脉夹层动脉瘤诊断中的临床价值.医药论坛杂志,2014,35(10):163-164.
• [33]Bertolotto ME,Derchi L,Cicero C,et al.Renal masses as characterized by ultrasound contrast.Ultrasound Clin,2013,8(4):581-592.
• [34]Clevert DA,Stickel M,Johnson T,et al.Imaging of aortic abnormalities with contrast-enhanced ultrasound.A pictorial comparison with CT.Eur Radiol,2007,17(11):2991-3000.
• [35]Clevert DA,Minaifar N,Weckbach S,et al.Color duplex ultrasound and contrast-enhanced ultrasound in comparison to MS-CT in the detection of endoleak following endovascular aneurysm repair.Clin Hemorheol Microcirc,2008,39(1-4):121-132.
• [36]郑艳玲,徐辉雄,黄雪玲,等.腹主动脉瘤超声造影表现与CT血管成像的比较.中华医学超声杂志(电子版),2010,7(5):783-788.
• [37]Cheng Z,Tan FP,Riga CV,et al.Analysis of flow patterns in a patient-specific aortic dissection model.J Biomech Eng,2010,132(5):051007.
• [38]Rudenick PA,Bordone M,Bijnens BH,et al.Influence of tear configuration on false and true lumen haemodynamics in type B aortic dissection.Conf Proc IEEE Eng Med Biol Soc,2010,2010:2509-2512.
• [39]Armerding MD,Rubin GD,Beaulieu CF,et al.Aortic aneurysmal disease:assessment of stent-graft treatment-CT versus conventional angiography.Radiology,2000,215(1):138-146.
• [40]刘永昌,胡何节,王晓天,等.多排螺旋CT及数字减影血管造影对B型主动脉夹层评估的意义.中国临床保健杂志,2012,13(1):88-91.
• [41]Rogers AM,Hermann LK,Booher AM,et al.Sensitivity of the aortic dissection detection risk score,a novel guideline-based tool for identification of acute aortic dissection at initial presentation:results from the international registry of acute aortic dissection.Circulation,2011,123(20):2213-2218.
• [42]Habets J,Zandvoort HJ,Reitsma JB,et al.Magnetic resonance imaging is more sensitive than computed tomography angiography for the detection of endoleaks after endovascular abdominal aortic aneurysm repair:a systematic review.Eur J Vasc Endovasc Surg,2013,45(4):340-350.
• [43]Rasche V,Oberhuber A,Trumpp S,et al.MRI assessment of thoracic stent grafts after emergency implantation in multi trauma patients:a feasibility study.Eur Radiol,2011,21(7):1397-1405.