Clinical analysis of endovascular repair with covered stent in the treatment of 40 patients with Stanford B type aortic dissection / 中国基层医药

ABSTRACT

Objective To evaluate the efficacy and safety of endovascular repair with covered stent in the treatment of Stanford B -type aortic dissection.Methods The clinical data of 40 patients with Stanford B -type aortic dissection who underwent endovascular repair with covered stent in the People 's Hospital of Suqian , Nanjing Drum-Tower Hospital Group from January 2012 to December 2017 were retrospectively analyzed .The incidence of complications before and after treatment , and its influence on the serum levels of IL -1β, INF -γ, VEGF were analyzed.After one year follow -up,the changes of quality of life score before and after surgery ,and the mortality, reoperation or interventional treatment within one year after operation were compared .Results Forty patients were successfully implanted with stent grafts ,5 cases of which had a small amount of endoleak ,1 case had postoperative cerebral infarction , and no complications such as paraplegia or renal failure were observed .Compared with before treatment,the serum levels of IL-1β,INF-γand VEGF were significantly down -regulated after treatment [(3.24 ± 0.19)ng/L vs.(2.02 ±1.16)ng/L,(2.65 ±0.23)ng/L vs.(1.14 ±1.27)ng/L,(1.51 ±0.17)ng/mL vs.(0.73 ± 0.34)ng/mL],the differences were statistically significant (t=5.037,P=0.001;t=6.071,P=0.000;t=7.314,P=0.000).After 1 year of follow-up,the mortality rate was 5.00％(2/40),and the rate of reoperation or intervention was 5.00％(2/40).The postoperative quality of life(QLQC-30) of the patients was scored in different dimensionsemotional function,body function,role function,cognitive function and social function after 1 month,6 months and 12 months,the differences were statistically significant (F=6.134,7.109,5.134,6.925,5.197,all P=0.000). Conclusion Endovascular repair with covered stent in the treatment of Stanford B aortic dissection can significantlyimprove the clinical symptoms of patients ,with significant effects and less complications ,and can significantly improve patients'survival and quality of life .