The application of bare-stent “chimney” technique in treating aortic dissection complicated by left common carotid rupture / 介入放射学杂志

Objective To discuss the application of bare-stent“chimney”technique in treating aortic dissection associated with left common carotid rupture, and to evaluate its therapeutic effect. Methods The clinical data of 7 patients with aortic dissection accompanied with left common carotid rupture, who were admitted to Qinghai Provincial People’s Hospital during the period from February 2012 to March 2014 to receive endovascular isolation operation treatment with bare-stent “chimney” technique, were retrospectively analyzed. When the rupture of aortic dissection was occluded with covered-stent, the left common carotid rupture was isolated with “chimney”bare-stent to reconstruct the blood flow of left common carotid artery. CT angiography was performed 2 weeks after the operation to check if there was any complication such as endoleak, stent migration, etc. Results The technical success rate of endovascular isolation operation was 100%. No type I endoleak occurred. The patients were followed up for 1-13 months, the covered stent in the aorta was in good position, and the “chimney” bare-stent in the left common carotid artery was patent. No complications such as endoleak, stent migration, etc. occurred. Conclusion Bare-stent“chimney”technology can provide treatment opportunity for the patients suffering from left common carotid artery rupture accompanied by aortic dissection; the rupture can be completely obstructed and the blood flow can be reconstructed. The short-term effect is satisfactory, although the long-term effect needs to be further studied.

Perioperative nursing of 22 patients with Stanford B type aortic dissections treated with endovascular graft exclusion / 现代临床护理

Objective To investigate the perioperative nursing of patients with Stanford type B aortic dissections treated with endovascular graft exclusion.Method The clinical data of 22 cases undergoing thoracic endovascular aortic repair from February 2011 to August 2013 were retrospectively analyzed to summarize the nursing experience.Results Twenty-two patients survived successfully through operation.One case had retrograde type A dissection after operation,another 15 had hyperthermia,and all of them were cured and discharged due to symptomatic treatment.The postoperative 3 months follow-up showed no type I endoleak.Conclusion Preoperative psychological nursing,postoperative blood pressure control,nursing of complications,strengthening instruction of diet and physical activity,are critical for the promotion of early rehabilitation of patients after discharge.

Endovascular repair for type B aortic dissection / 中华普通外科杂志

Objective To evaluate thoracic endovascular aortic repair for type B aortic dissection.Methods Chnical data were reviewed on 126 cases with type B aortic dissection undergoing endovascular aortic repair in our hospital from January 2006 to April 2011.There were 86 male patients and 40 female patients,age from 32 to 82 years.The stent- grafts were introduced via femoral arteriotomy.Stent-grafts were implanted to blockade tears of aortic dissection under the guidance of DSA.Postoperatively patients were followed-up by angiography and imiging for endoleak,stent migration,and fracture of stent-graft.Results In all cases,the aortic dissection tears were closed,true lumens were opened,and organ function was restored.There were not complications such as internal hemorrhage due to trauma or stent displacement on CTA from 3 to 63 months after endovascular therapy.Procedure was successful in all 126 cases,157 stents were released,2 cases died in the perioperative period,1 case died during the followed-up.A breach was found at the end of the stent in 12 cases,endovascular aortic repair redone successfully with a retrograde type A dissection found during follow-up.Conclusions Endovascular aortic repair is safe and effective for patients with Stanford type B aortic dissection with a favorable outcomes.

Endovascular therapy for Stanford type B aorta dissection / 中国普通外科杂志

Objective To evaluate the methods,applicability and results of cndovascular therapy for Stanford type B aortic dissection.Methods The clinical data of 36 cases of Stanford type B aortic dissection were analysed retrospectively.The stent-grafts were introduced via femoral arteriotomy.Stent-grafts were implanted to blockade tears of aortic dissection under the guidance of DSA.Results In all cases,the aortic dissection tears were blockaded,true lumens were opened,and organs function was restored.There were not complications such as internal hemorrhage due to trauma or stent displacement on CTA 3 and 12 months after endovascular therapywhile 2 cases developed new tears.The caliber of the 36 true lumens was restored to near normal.Twenty-two pseudocoeloms were obliterated,while the others were reduced is size and had varying degrees of thrombosis.Conclusions Endovascular thcrapy is safe and effectivc for the patients with Stanford type B aortic dissection.Its clinical application has a favorable outlook.