Abstract
目的 探讨覆膜血管内支架置入术对主动脉夹层腹部重要血管分支血流的影响. 方法 35例B 型主动脉夹层接受覆膜血管内支架治疗,通过术前后电子束CT、MRI与DSA资料分析,比较术前后腹部重要血管分支影像学变化. 结果 35例共计140支腹腔内脏主要血管分支(包括腹腔动脉、肠系膜上动脉及左右肾动脉),术前经影像学资料综合判断,血流受损血管58支,其中14支为动力型受损,占10.0%(14/140支);44支为静力型血流受损,占31.4%(44/140支).覆膜血管内支架置入后14支动力型受损的血管分支血流全部改善;44支静力型分支均显示不同程度血流改善,管腔狭窄程度减轻,对比剂充盈和排空速度加快,术后无缺血并发症. 结论覆膜血管内支架置入术不仅能改善B 型主动脉夹层所致的血管分支动力型缺血,对多数静力型受损的血管也有明显的即时血流改善作用,但中远期效果有待进一步观察。
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