Kết quả can thiệp nội mạch cấp cứu điều trị vỡ phình động mạch chủ ngực đoạn xuống

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Tác giả: Duy Kiên Phan, Quyết Tiến Trần

Ngôn ngữ: Vie

Ký hiệu phân loại: 612.1 Blood and circulation

Thông tin xuất bản: Phẫu thuật Tim mạch và Lồng ngực việt nam 2021

Mô tả vật lý: 45646

Bộ sưu tập: Metadata

ID: 408531

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Chủ đề

Nghiên cứu mô tả hàng loạt ca với 31bệnh nhân có bệnh lý động mạch chủ được can thiệp cấp cứu đặt stent graft từ tháng 05/2012 đến tháng 12/2019tại khoa Phẫu thuật Mạch máu bệnh viện Chợ Rẫy. Kết quả: Nghiên cứu có 31bệnh nhân, nam giới chiếm 80,7%, tuổi trung bình là 64± 15,1. Thời gian theo dõi trung bình là 18,6 tháng. Tỷ lệ chuyển vị các nhánh động mạch nuôi tạng và động mạch trên quai động mạch chủ để có vùng hạ đặt ống ghép thích hợp là 12,9 %, tỷ lệ phủ động mạch dưới đòn trái là29%, tỷ lệ gây tê tại chỗ 38,8 %. Tỷ lệ bung ống ghép thành công là 100%. Tỷ lệ tử vong chu phẫu và trung hạn lần lượt là 6,4% và 31%.Về biến chứng liên quan đến kỹ thuật sau 30 ngày, chúng tôi ghi nhận có 6 trường hợp rò ống ghép loại II nhưng không trường hợp nào cần can thiệp lại, có 1 trường hợp rò ống ghép thực quản tử vong do nhiễm trùng huyết, 1 trường hợp vỡ túi phình do tăng kích thước túi phình trong thờigian theo dõi., Tóm tắt tiếng anh, Case series with 31patients with ruptured descending thoracic aortic aneurysmstreated by stent graft at Vascular Surgery department, Cho Ray hospital from 05/2012 to 12/2019.Results:31patients were treated with stent graft for ruptureddescending thoracic aneurysms.The mean age was 64± 15,1, 80,7 % were men, mean follow-up time was 18,6months. The rate of patients needed aortic arch and visceral debranching to have sufficent sealing zone was 12,9%. 29 % of patients had subclavian arterial coverage. The rate of local anesthesia was 38,8 %. Perioperative and mid-term mortality rates were 6,4 % and 31 %. 100 % cases were successfully deployed.Technical related complications were type II endoleak (6 cases but none of that needed to re-intervention), 1 case of secondary aorto-esophageal fistula died due to sepsisand 1 case of secondary rupture due to aneurysm expansion.

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