Clinical effect of endovascular graft exclusion of aorta in treatment of type-DebakeyⅢ aortic dissection

DING Hong; SUN Chao-yang; MA Xiang

doi:10.3969/j.issn.1674-4055.2016.11.09

Abstract：Objective To summarize the efficacy of endovascular graft exclusion of aorta (EVGA) in patients with type-Debakey Ⅲ aortic dissection.Methods The materials of 39 patients (male 34, female 5, aged from 37 to 69 and average age=55.0±10.4) were retrospectively analyzed after EVGA in the Central Hospital of Ankang City from Jun. 2012 to Jan. 2015. The situations of stenting and operation were analyzed. All patients were given CT angiography (CTA) before and after EVGA, and the measured value changes of true and false lumen diameters in different horizontal planes (proximal crevasse level, diaphragm level and tumor body) were compared. The curative effect was reviewed, and the patients were followed up after the operation. The prognosis and endoleak were observed.Results There were totally 42 stents implanted in 39 patients, and 3 patients with 2 stents. The range of stent length was from 40.0 mm to 200.0 mm and average length was (113.5±41.7) mm. The range of stent diameter was from 26.0 mm to 42.0 mm and average diameter was (34.1±4.9) mm. The duration time of EVGA was from 2.7 h to 4.8 h and average time was (3.1±0.7) h, and bleeding volume was from 30.0 mL to 109 mL and average volume was (67.4 ±28.1) mL. There was one patients died during perioperative period. There were 35 patients (89.74%) achieved complete exclusion and 3 patients had endoleak after EVGA. The measured values of true lumen diameters of proximal crevasse level, diaphragm level and tumor body were significantly higher after EVGA (all P<0.05). The measured values of false lumen diameters of proximal crevasse level, diaphragm level and tumor body were significantly lower after EVGA (allP<0.05).Conclusion The curative effect of EVGA is reliable and safe on type-Debakey Ⅲ aortic dissection, which is worth to be popularized and applied in clinic.