B型主动脉夹层腔内修复术及保守治疗效果的对比研究
|
摘要
目的本研究为国内首个关于B型主动脉夹层的多中心、前瞻性注册研究，主要比较主动脉腔内修复术（TEVAR）和药物保守治疗（OMT）对于B型夹层的早期和中期结果。
方法本研究纳入自2007年1月至2010年12月国内四家血管中心收治的335名B型主动脉夹层患者，其中32例为复杂型夹层，303例诊断为非复杂型夹层，其中208例纳入TEVAR治疗组，95例纳入OMT治疗组。男性246例，女性89例，平均年龄53.7±18.1岁。ASA评分大于III级者51例（15.2％，51/335）。合并严重并发症包括12例肾脏缺血，8例肠缺血，16例先兆破裂，11例下肢缺血，1例截瘫。初始影像学资料显示，第一破口距LSA开口距离为32.6±28.9mm，294例（87.8%）夹层同时累及胸腹主动脉，41例（12.2％）夹层局限撕裂至胸主动脉水平，初始胸主动脉最大直径41.2±19.1mm；腹主动脉最大直径28.1±19.3mm。
结果本组病例TEVAR操作技术成功率100％，40％（96/240）患者需要覆盖左侧锁骨下动脉，有15例（6.25％）患者需要腹膜外入路。复杂型夹层组中，6例患者住院期间死亡，死亡率为18.7％（6/32），脊髓损伤发生于3名（9.4％，3/32）患者。Logistic多因素逐步回归分析显示，ASA评分大于III级为围手术期死亡率独立危险因素。OMT组围手术期没有死亡及严重不良事件发生。非复杂TEVAR组中，2例（0.9％，2/208）患者术中发生逆行A型夹层，2例（0.9％，2/208）患者发生急性心急梗塞，6例（0.9％，2/208）患者术后发生肱动脉穿刺点假性动脉瘤。Logistic多因素逐步回归分析显示，年龄大于75岁为围手术期不良事件发生的独立危险因素。所有病例平均随访时间28.5±16.3月（范围1－58月），68％患者随访时间超过24月。Kaplan-Meier生存曲线分析显示，复杂型夹层48月生存率为61.7％，非主动脉相关生存率48月估计为70％，无主动脉相关不良事件的生存率48月为56.3％。TEVAR组48月生存率为82.7％，而OMT组48月生存率为69.1％，Log-rank检验两组没有统计学差异（P=0.0678）。非主动脉相关死亡的生存率曲线分析，TEVAR组48月生存率为88.1％；OMT组48月为73.8％，Log-rank检验两组间有统计学差异（P=0.0392）。TEVAR组中，有94.9％（151/159）患者主动脉没有进一步增长，胸主动脉最大直径自基线值41.5＋11.1mm缩小至37.3＋12.8mm；OMT组中，有39.7％（27/68）患者主动脉没有持续增长，胸主动脉直径增加的患者比例明显高于TEVAR组（P＝0.001）。OMT组主动脉最大直径自基线值40.7＋8.6mm增长至48.1＋9.3mm，同TEVAR组差别有统计学意义（P＝0.002）。TEVAR组胸主动脉完全血栓和重塑率达到88.4％（157/177），而在OMT组则只有22.1％（15/68），两组间差别有统计学意义（P＝0.001）。
结论本研究初步表明，与OMT治疗相比，TEVAR治疗可以显著降低主动脉相关死亡率，可能会提高整体生存率和降低主动脉相关不良事件发生率，虽然后面两个参数在本研究中未呈现统计学差异。另外，与OMT治疗相比，TEVAR治疗可以促进夹层假腔血栓形成，提高胸主动脉重塑率，减少胸主动脉直径增长的风险。
Objective: This prospective multi-center comparative study examined earlyand midterm results of medication and stentgraft therapies on the type Baorta dissection in China.
Methods:335patients collected from four centers in China from January2007to Dec2010with type B aorta dissection were prospectively enrolledand treated by either optimal medication therapy (OMT) or thoracicendovascular aorta repair (TEVAR). There were246male and89femalepatients with an age of53.7±18.1years. American Society ofAnesthesiologists (ASA) classification greater than class III was present in15.2%patients. The baseline maximum diameter of thoracic aorta was41.2±19.1mm, the distance from the left subclavian artery to the proximal entrytear was32.6±28.9mm, and dissection extended beyond the celiac axis in87.8%of cases.
Results: there were208patients in the TEVAR group and95patients in theOMT group. Procedural success was100%, and there was no death duringindex hospitalization in both groups. In the TEVAR group, two patients(0.9%) suffered from retrograde type A dissection, six (2.9%) from brachialaccess pseudo-aneurysm, and two (0.9%) suffered from paraplegia orparaparesis. For in-hospital outcome, multivariate analysis showed that agegreater than75years and ASA class greater than III were independentpredictors of major early adverse events. Average follow-up time for hospitalsurvivors was28.5±16.3months (range1.0–58). In the OMT group, fivepatients died for rupture of enlarged false lumen, and six patients expiredsuddenly for unknown reasons. Fourteen cases required crossover to TEVAR (n=12) or surgical conversion (n=2). In the TEVAR group, ninepatients required reintervention or surgical conversion, and one died ofpostoperative multi-organ failure. One patient expired for delayedretrograde type A dissection, and four expired suddenly for unknownreasons. The Kaplan-Meier analysis of survival probability at two years andfour years was87.5%and82.7%with TEVAR and77.5%and69.1%respectively with OMT (log-rank test P=0.0678). The estimated cumulativefreedom from aorta-related death at two and four years were91.6%and88.1%with TEVAR and82.8%and73.8%with OMT (log-rank testP=0.0392). The maximum thoracic aorta shrank from42.4±23.1mm to37.3±12.8mm in the TEVAR group, and the maximum thoracic aorta in theOMT group expanded from40.7±18.6mm to48.1±17.3mm. Theincidence of increased thoracic aorta is significantly higher in the OMT(60.3%) than in the TEVAR (5.1%)(P=0.001).
Conclusion: This was the first prospective multi-center comparative study onthe treatment of type B aorta dissection in China. TEVAR turned out to havea significantly lower aorta-related mortality compared with OMT, and aseemingly lower overall mortality and adverse events rate. Furthermore,TEVAR was also found to be able to enhance the thoracic remodeling rate.
方法本研究纳入自2007年1月至2010年12月国内四家血管中心收治的335名B型主动脉夹层患者，其中32例为复杂型夹层，303例诊断为非复杂型夹层，其中208例纳入TEVAR治疗组，95例纳入OMT治疗组。男性246例，女性89例，平均年龄53.7±18.1岁。ASA评分大于III级者51例（15.2％，51/335）。合并严重并发症包括12例肾脏缺血，8例肠缺血，16例先兆破裂，11例下肢缺血，1例截瘫。初始影像学资料显示，第一破口距LSA开口距离为32.6±28.9mm，294例（87.8%）夹层同时累及胸腹主动脉，41例（12.2％）夹层局限撕裂至胸主动脉水平，初始胸主动脉最大直径41.2±19.1mm；腹主动脉最大直径28.1±19.3mm。
结果本组病例TEVAR操作技术成功率100％，40％（96/240）患者需要覆盖左侧锁骨下动脉，有15例（6.25％）患者需要腹膜外入路。复杂型夹层组中，6例患者住院期间死亡，死亡率为18.7％（6/32），脊髓损伤发生于3名（9.4％，3/32）患者。Logistic多因素逐步回归分析显示，ASA评分大于III级为围手术期死亡率独立危险因素。OMT组围手术期没有死亡及严重不良事件发生。非复杂TEVAR组中，2例（0.9％，2/208）患者术中发生逆行A型夹层，2例（0.9％，2/208）患者发生急性心急梗塞，6例（0.9％，2/208）患者术后发生肱动脉穿刺点假性动脉瘤。Logistic多因素逐步回归分析显示，年龄大于75岁为围手术期不良事件发生的独立危险因素。所有病例平均随访时间28.5±16.3月（范围1－58月），68％患者随访时间超过24月。Kaplan-Meier生存曲线分析显示，复杂型夹层48月生存率为61.7％，非主动脉相关生存率48月估计为70％，无主动脉相关不良事件的生存率48月为56.3％。TEVAR组48月生存率为82.7％，而OMT组48月生存率为69.1％，Log-rank检验两组没有统计学差异（P=0.0678）。非主动脉相关死亡的生存率曲线分析，TEVAR组48月生存率为88.1％；OMT组48月为73.8％，Log-rank检验两组间有统计学差异（P=0.0392）。TEVAR组中，有94.9％（151/159）患者主动脉没有进一步增长，胸主动脉最大直径自基线值41.5＋11.1mm缩小至37.3＋12.8mm；OMT组中，有39.7％（27/68）患者主动脉没有持续增长，胸主动脉直径增加的患者比例明显高于TEVAR组（P＝0.001）。OMT组主动脉最大直径自基线值40.7＋8.6mm增长至48.1＋9.3mm，同TEVAR组差别有统计学意义（P＝0.002）。TEVAR组胸主动脉完全血栓和重塑率达到88.4％（157/177），而在OMT组则只有22.1％（15/68），两组间差别有统计学意义（P＝0.001）。
结论本研究初步表明，与OMT治疗相比，TEVAR治疗可以显著降低主动脉相关死亡率，可能会提高整体生存率和降低主动脉相关不良事件发生率，虽然后面两个参数在本研究中未呈现统计学差异。另外，与OMT治疗相比，TEVAR治疗可以促进夹层假腔血栓形成，提高胸主动脉重塑率，减少胸主动脉直径增长的风险。
Objective: This prospective multi-center comparative study examined earlyand midterm results of medication and stentgraft therapies on the type Baorta dissection in China.
Methods:335patients collected from four centers in China from January2007to Dec2010with type B aorta dissection were prospectively enrolledand treated by either optimal medication therapy (OMT) or thoracicendovascular aorta repair (TEVAR). There were246male and89femalepatients with an age of53.7±18.1years. American Society ofAnesthesiologists (ASA) classification greater than class III was present in15.2%patients. The baseline maximum diameter of thoracic aorta was41.2±19.1mm, the distance from the left subclavian artery to the proximal entrytear was32.6±28.9mm, and dissection extended beyond the celiac axis in87.8%of cases.
Results: there were208patients in the TEVAR group and95patients in theOMT group. Procedural success was100%, and there was no death duringindex hospitalization in both groups. In the TEVAR group, two patients(0.9%) suffered from retrograde type A dissection, six (2.9%) from brachialaccess pseudo-aneurysm, and two (0.9%) suffered from paraplegia orparaparesis. For in-hospital outcome, multivariate analysis showed that agegreater than75years and ASA class greater than III were independentpredictors of major early adverse events. Average follow-up time for hospitalsurvivors was28.5±16.3months (range1.0–58). In the OMT group, fivepatients died for rupture of enlarged false lumen, and six patients expiredsuddenly for unknown reasons. Fourteen cases required crossover to TEVAR (n=12) or surgical conversion (n=2). In the TEVAR group, ninepatients required reintervention or surgical conversion, and one died ofpostoperative multi-organ failure. One patient expired for delayedretrograde type A dissection, and four expired suddenly for unknownreasons. The Kaplan-Meier analysis of survival probability at two years andfour years was87.5%and82.7%with TEVAR and77.5%and69.1%respectively with OMT (log-rank test P=0.0678). The estimated cumulativefreedom from aorta-related death at two and four years were91.6%and88.1%with TEVAR and82.8%and73.8%with OMT (log-rank testP=0.0392). The maximum thoracic aorta shrank from42.4±23.1mm to37.3±12.8mm in the TEVAR group, and the maximum thoracic aorta in theOMT group expanded from40.7±18.6mm to48.1±17.3mm. Theincidence of increased thoracic aorta is significantly higher in the OMT(60.3%) than in the TEVAR (5.1%)(P=0.001).
Conclusion: This was the first prospective multi-center comparative study onthe treatment of type B aorta dissection in China. TEVAR turned out to havea significantly lower aorta-related mortality compared with OMT, and aseemingly lower overall mortality and adverse events rate. Furthermore,TEVAR was also found to be able to enhance the thoracic remodeling rate.
引文
1Svensson LG, Kouchoukos NT, Miller DC, Bavaria JE, Coselli JS, Curi MA,et al. Expert consensus document on the treatment of descending thoracicaortic disease using endovascular stentgrafts. Ann Thorac Surg2008;85(1Suppl.):S1-41.
2Nordon IM, Hinchliffe RJ, Loftus IM, Morgan RA, Thompson MM.Management of acute aortic syndrome and chronic aortic dissection.Cardiovasc Intervent Radiol;2011;34(5):890-902
3Eggebrecht H, Nienaber CA, Neuhauser M, Baumgart D,Kische S,Schmermund A, et al. Endovascular stent-graft placement in aorticdissection: a meta-analysis. Eur Heart J,2006;27(4):489-98.
4Nienaber CA, Rousseau H, Eggebrecht H, Kische S, Fattori R, RehdersTC, et al. Randomized comparison of strategies for type B aortic dissection:the INvestigation of STEnt grafts in aortic dissection (INSTEAD) trial.Circulation2009;120(25):2519-28.
5Tsai TT, Fattori R, Trimarchi S, Isselbacher E, Myrmel T, Evangelista A,Hutchison S, Sechtem U, Cooper JV, Smith DE, Pape L, Froehlich J,Raghupathy A, Januzzi JL, Eagle KA, Nienaber CA; International Registryof Acute Aortic Dissection. Long-term survival in patients presenting withtype B acute aortic dissection: insights from the International Registry ofAcute Aortic Dissection. Circulation.2006;114:2226–2231.
6Kim U, Hong SJ, Kim J, Kim JS, Ko YG, Choi D, et al. Intermediate tolong-term outcomes of endoluminal stent-graft repair in patients with chronictype B aortic dissection. J Endovasc Ther2009;16(1):42-7.
7Xiong J, Jiang B, Guo W, Wang SM, Tong XY. Endovascular stent graftplacement in patients with type B aortic dissection: a meta-analysis in China.J Thorac Cardiovasc Surg.2009Oct;138(4):865-72.
8Xu SD, Huang FJ, Yang JF, Li ZZ, Yang S, Du JH, et al. Early andmidterm results of thoracic endovascular aortic repair of chronic type Baortic dissection. J Thorac Cardiovasc Surg2010;139(6):1548-53.
9Guangqi C, Xiaoxi L, Wei C, Songqi L, Chen Y, Zilun L, et al.Endovascular repair of stanford type B aortic dissection: early and mid-termoutcomes of121cases. Eur J Vasc Endovasc Surg2009;38(4):422-6.
10. Chaikof EL, Blankensteijn JD, Harris PL, White GH, Zarins CK,Bernhard VM, Matsumura JS, May J, Veith FJ, Fillinger MF, Rutherford RB,Kent KC; Ad Hoc Committee for Standardized Reporting Practices inVascular Surgery of the Society for Vascular Surgery/American Associationfor Vascular Surgery. Reporting standards for endovascular aorticaneurysm repair. J Vasc Surg.2002;35:1048–1060.
11Desai ND, Pochettino A, Szeto WY, Moser GW, Moeller PJ, Sodhi N,Jackson B, Woo E, Fairman RM, Bavaria J. Thoracic endovascular aorticrepair: evolution of therapy, patterns of use, and results in a10-yearexperience. J Thorac Cardiovasc Surg.2011Sep;142(3):587-94.
12Kusagawa H, Shimono T, Ishida M, Suzuki T, Yasuda F, Yuasa U, et al.Changes in false lumen after transluminal stent-graft placement in aorticdissections: six years’ experience. Circulation2005;111(22):2951-7.
13Resch TA, Delle M, Falkenberg M, Ivancev K, Konrad P, Larzon T, et al.Remodeling of the thoracic aorta after stent grafting of type B dissection: aSwedish multicenter study. J Cardiovasc Surg2006;47(5):503-8.
1Svensson LG, Kouchoukos NT, Miller DC, Bavaria JE, Coselli JS, Curi MA,et al. Expert consensus document on the treatment of descending thoracicaortic disease using endovascular stentgrafts. Ann Thorac Surg2008;85(1Suppl.):S1-41.
2Nordon IM, Hinchliffe RJ, Loftus IM, Morgan RA, Thompson MM.Management of acute aortic syndrome and chronic aortic dissection.Cardiovasc Intervent Radiol;2011;34(5):890-902
3Eggebrecht H, Nienaber CA, Neuhauser M, Baumgart D,Kische S,Schmermund A, et al. Endovascular stent-graft placement in aorticdissection: a meta-analysis. Eur Heart J,2006;27(4):489-98.
4Nienaber CA, Rousseau H, Eggebrecht H, Kische S, Fattori R, RehdersTC, et al. Randomized comparison of strategies for type B aortic dissection:the INvestigation of STEnt grafts in aortic dissection (INSTEAD) trial.Circulation2009;120(25):2519-28.
5Sueyoshi E, Sakamoto I, Hayashi K, Yamaguchi T, Imada T. Growth rateof aortic diameter in patients with type B aortic dissection during the chronicphase. Circulation2004;110(11Suppl.1):II256-61.
6Tsai TT, Fattori R, Trimarchi S, Isselbacher E, Myrmel T, Evangelista A,Hutchison S, Sechtem U, Cooper JV, Smith DE, Pape L, Froehlich J,Raghupathy A, Januzzi JL, Eagle KA, Nienaber CA; International Registryof Acute Aortic Dissection. Long-term survival in patients presenting withtype B acute aortic dissection: insights from the International Registry ofAcute Aortic Dissection. Circulation.2006;114:2226–2231.
7Subramanian S, Roselli EE. Thoracic aortic dissection: long-term resultsof endovascular and open repair. Semin Vasc Surg2009;22(2):61-8.
8Thrumurthy SG, Karthikesalingam A, Patterson BO, Holt PJ, Hinchliffe RJ,Loftus IM, Thompson MM. A systematic review of mid-term outcomes ofthoracic endovascular repair (TEVAR) of chronic type B aortic dissection.Eur J Vasc Endovasc Surg.2011Nov;42(5):632-47.
9Kang WC, Greenberg RK, Mastracci TM, Eagleton MJ, Hernandez AV,Pujara AC, Roselli EE. Endovascular repair of complicated chronic distalaortic dissections: intermediate outcomes and complications. J ThoracCardiovasc Surg.2011Nov;142(5):1074-83.
10Parsa CJ, Schroder JN, Daneshmand MA, McCann RL, Hughes GC.Midterm results for endovascular repair of complicated acute and chronictype B aortic dissection. Ann Thorac Surg2010;89(1):97-104.
11Kim U, Hong SJ, Kim J, Kim JS, Ko YG, Choi D, et al. Intermediate tolong-term outcomes of endoluminal stent-graft repair in patients with chronictype B aortic dissection. J Endovasc Ther2009;16(1):42-7.
12Oberhuber A, Winkle P, Schelzig H, Orend KH, Muehling BM. Technicaland clinical success after endovascular therapy for chronic type B aorticdissections. J Vasc Surg.2011Nov;54(5):1303-9.
13Xiong J, Jiang B, Guo W, Wang SM, Tong XY. Endovascular stent graftplacement in patients with type B aortic dissection: a meta-analysis in China.J Thorac Cardiovasc Surg.2009Oct;138(4):865-72.
14Xu SD, Huang FJ, Yang JF, Li ZZ, Yang S, Du JH, et al. Early andmidterm results of thoracic endovascular aortic repair of chronic type Baortic dissection. J Thorac Cardiovasc Surg2010;139(6):1548-53.
15Guangqi C, Xiaoxi L, Wei C, Songqi L, Chen Y, Zilun L, et al.Endovascular repair of stanford type B aortic dissection: early and mid-termoutcomes of121cases. Eur J Vasc Endovasc Surg2009;38(4):422-6.
16Jing QM, Han YL, Wang XZ, Deng J, Luan B, Jin HX, et al. Endovascularstent-grafts for acute and chronic type B aortic dissection: comparison ofclinical outcomes. Chin Med J2008;121(22):2213-7.17. Chaikof EL, Blankensteijn JD, Harris PL, White GH, Zarins CK,Bernhard VM, Matsumura JS, May J, Veith FJ, Fillinger MF, Rutherford RB,Kent KC; Ad Hoc Committee for Standardized Reporting Practices inVascular Surgery of the Society for Vascular Surgery/American Associationfor Vascular Surgery. Reporting standards for endovascular aorticaneurysm repair. J Vasc Surg.2002;35:1048–1060.
18Parker JD, Golledge J. Outcome of endovascular treatment of acute typeB aortic dissection. Ann Thorac Surg2008;86(5):1707-12.
19Song TK, Donayre CE, Walot I, Kopchok GE, Litwinski RA, Lippmann M,et al. Endograft exclusion of acute and chronic descending thoracic aorticdissections. J Vasc Surg2006;43(2):247-58.
20Desai ND, Pochettino A, Szeto WY, Moser GW, Moeller PJ, Sodhi N,Jackson B, Woo E, Fairman RM, Bavaria J. Thoracic endovascular aorticrepair: evolution of therapy, patterns of use, and results in a10-yearexperience. J Thorac Cardiovasc Surg.2011Sep;142(3):587-94.
21Parsa CJ, Williams JB, Bhattacharya SD, Wolfe WG, Daneshmand MA,McCann RL, Hughes GC. Midterm results with thoracic endovascular aorticrepair for chronic type B aortic dissection with associated aneurysm. JThorac Cardiovasc Surg.2011Feb;141(2):322-7.
22Kusagawa H, Shimono T, Ishida M, Suzuki T, Yasuda F, Yuasa U, et al.Changes in false lumen after transluminal stent-graft placement in aorticdissections: six years’ experience. Circulation2005;111(22):2951-7.
23Sayer D, Bratby M, Brooks M, Loftus I, Morgan R, Thompson M. Aorticmorphology following endovascular repair of acute and chronic type B aorticdissection: implications for management. Eur J Vasc Endovasc Surg2008;36(5):522-9.
24Resch TA, Delle M, Falkenberg M, Ivancev K, Konrad P, Larzon T, et al.Remodeling of the thoracic aorta after stent grafting of type B dissection: aSwedish multicenter study. J Cardiovasc Surg2006;47(5):503-8.
25Rodriguez JA, Olsen DM, Lucas L, Wheatley G, Ramaiah V, DiethrichEB. Aortic remodeling after endografting of thoracoabdominal aorticdissection. J Vasc Surg2008;47(6):1188-94.
2Nordon IM, Hinchliffe RJ, Loftus IM, Morgan RA, Thompson MM.Management of acute aortic syndrome and chronic aortic dissection.Cardiovasc Intervent Radiol;2011;34(5):890-902
3Eggebrecht H, Nienaber CA, Neuhauser M, Baumgart D,Kische S,Schmermund A, et al. Endovascular stent-graft placement in aorticdissection: a meta-analysis. Eur Heart J,2006;27(4):489-98.
4Nienaber CA, Rousseau H, Eggebrecht H, Kische S, Fattori R, RehdersTC, et al. Randomized comparison of strategies for type B aortic dissection:the INvestigation of STEnt grafts in aortic dissection (INSTEAD) trial.Circulation2009;120(25):2519-28.
5Tsai TT, Fattori R, Trimarchi S, Isselbacher E, Myrmel T, Evangelista A,Hutchison S, Sechtem U, Cooper JV, Smith DE, Pape L, Froehlich J,Raghupathy A, Januzzi JL, Eagle KA, Nienaber CA; International Registryof Acute Aortic Dissection. Long-term survival in patients presenting withtype B acute aortic dissection: insights from the International Registry ofAcute Aortic Dissection. Circulation.2006;114:2226–2231.
6Kim U, Hong SJ, Kim J, Kim JS, Ko YG, Choi D, et al. Intermediate tolong-term outcomes of endoluminal stent-graft repair in patients with chronictype B aortic dissection. J Endovasc Ther2009;16(1):42-7.
7Xiong J, Jiang B, Guo W, Wang SM, Tong XY. Endovascular stent graftplacement in patients with type B aortic dissection: a meta-analysis in China.J Thorac Cardiovasc Surg.2009Oct;138(4):865-72.
8Xu SD, Huang FJ, Yang JF, Li ZZ, Yang S, Du JH, et al. Early andmidterm results of thoracic endovascular aortic repair of chronic type Baortic dissection. J Thorac Cardiovasc Surg2010;139(6):1548-53.
9Guangqi C, Xiaoxi L, Wei C, Songqi L, Chen Y, Zilun L, et al.Endovascular repair of stanford type B aortic dissection: early and mid-termoutcomes of121cases. Eur J Vasc Endovasc Surg2009;38(4):422-6.
10. Chaikof EL, Blankensteijn JD, Harris PL, White GH, Zarins CK,Bernhard VM, Matsumura JS, May J, Veith FJ, Fillinger MF, Rutherford RB,Kent KC; Ad Hoc Committee for Standardized Reporting Practices inVascular Surgery of the Society for Vascular Surgery/American Associationfor Vascular Surgery. Reporting standards for endovascular aorticaneurysm repair. J Vasc Surg.2002;35:1048–1060.
11Desai ND, Pochettino A, Szeto WY, Moser GW, Moeller PJ, Sodhi N,Jackson B, Woo E, Fairman RM, Bavaria J. Thoracic endovascular aorticrepair: evolution of therapy, patterns of use, and results in a10-yearexperience. J Thorac Cardiovasc Surg.2011Sep;142(3):587-94.
12Kusagawa H, Shimono T, Ishida M, Suzuki T, Yasuda F, Yuasa U, et al.Changes in false lumen after transluminal stent-graft placement in aorticdissections: six years’ experience. Circulation2005;111(22):2951-7.
13Resch TA, Delle M, Falkenberg M, Ivancev K, Konrad P, Larzon T, et al.Remodeling of the thoracic aorta after stent grafting of type B dissection: aSwedish multicenter study. J Cardiovasc Surg2006;47(5):503-8.
1Svensson LG, Kouchoukos NT, Miller DC, Bavaria JE, Coselli JS, Curi MA,et al. Expert consensus document on the treatment of descending thoracicaortic disease using endovascular stentgrafts. Ann Thorac Surg2008;85(1Suppl.):S1-41.
2Nordon IM, Hinchliffe RJ, Loftus IM, Morgan RA, Thompson MM.Management of acute aortic syndrome and chronic aortic dissection.Cardiovasc Intervent Radiol;2011;34(5):890-902
3Eggebrecht H, Nienaber CA, Neuhauser M, Baumgart D,Kische S,Schmermund A, et al. Endovascular stent-graft placement in aorticdissection: a meta-analysis. Eur Heart J,2006;27(4):489-98.
4Nienaber CA, Rousseau H, Eggebrecht H, Kische S, Fattori R, RehdersTC, et al. Randomized comparison of strategies for type B aortic dissection:the INvestigation of STEnt grafts in aortic dissection (INSTEAD) trial.Circulation2009;120(25):2519-28.
5Sueyoshi E, Sakamoto I, Hayashi K, Yamaguchi T, Imada T. Growth rateof aortic diameter in patients with type B aortic dissection during the chronicphase. Circulation2004;110(11Suppl.1):II256-61.
6Tsai TT, Fattori R, Trimarchi S, Isselbacher E, Myrmel T, Evangelista A,Hutchison S, Sechtem U, Cooper JV, Smith DE, Pape L, Froehlich J,Raghupathy A, Januzzi JL, Eagle KA, Nienaber CA; International Registryof Acute Aortic Dissection. Long-term survival in patients presenting withtype B acute aortic dissection: insights from the International Registry ofAcute Aortic Dissection. Circulation.2006;114:2226–2231.
7Subramanian S, Roselli EE. Thoracic aortic dissection: long-term resultsof endovascular and open repair. Semin Vasc Surg2009;22(2):61-8.
8Thrumurthy SG, Karthikesalingam A, Patterson BO, Holt PJ, Hinchliffe RJ,Loftus IM, Thompson MM. A systematic review of mid-term outcomes ofthoracic endovascular repair (TEVAR) of chronic type B aortic dissection.Eur J Vasc Endovasc Surg.2011Nov;42(5):632-47.
9Kang WC, Greenberg RK, Mastracci TM, Eagleton MJ, Hernandez AV,Pujara AC, Roselli EE. Endovascular repair of complicated chronic distalaortic dissections: intermediate outcomes and complications. J ThoracCardiovasc Surg.2011Nov;142(5):1074-83.
10Parsa CJ, Schroder JN, Daneshmand MA, McCann RL, Hughes GC.Midterm results for endovascular repair of complicated acute and chronictype B aortic dissection. Ann Thorac Surg2010;89(1):97-104.
11Kim U, Hong SJ, Kim J, Kim JS, Ko YG, Choi D, et al. Intermediate tolong-term outcomes of endoluminal stent-graft repair in patients with chronictype B aortic dissection. J Endovasc Ther2009;16(1):42-7.
12Oberhuber A, Winkle P, Schelzig H, Orend KH, Muehling BM. Technicaland clinical success after endovascular therapy for chronic type B aorticdissections. J Vasc Surg.2011Nov;54(5):1303-9.
13Xiong J, Jiang B, Guo W, Wang SM, Tong XY. Endovascular stent graftplacement in patients with type B aortic dissection: a meta-analysis in China.J Thorac Cardiovasc Surg.2009Oct;138(4):865-72.
14Xu SD, Huang FJ, Yang JF, Li ZZ, Yang S, Du JH, et al. Early andmidterm results of thoracic endovascular aortic repair of chronic type Baortic dissection. J Thorac Cardiovasc Surg2010;139(6):1548-53.
15Guangqi C, Xiaoxi L, Wei C, Songqi L, Chen Y, Zilun L, et al.Endovascular repair of stanford type B aortic dissection: early and mid-termoutcomes of121cases. Eur J Vasc Endovasc Surg2009;38(4):422-6.
16Jing QM, Han YL, Wang XZ, Deng J, Luan B, Jin HX, et al. Endovascularstent-grafts for acute and chronic type B aortic dissection: comparison ofclinical outcomes. Chin Med J2008;121(22):2213-7.17. Chaikof EL, Blankensteijn JD, Harris PL, White GH, Zarins CK,Bernhard VM, Matsumura JS, May J, Veith FJ, Fillinger MF, Rutherford RB,Kent KC; Ad Hoc Committee for Standardized Reporting Practices inVascular Surgery of the Society for Vascular Surgery/American Associationfor Vascular Surgery. Reporting standards for endovascular aorticaneurysm repair. J Vasc Surg.2002;35:1048–1060.
18Parker JD, Golledge J. Outcome of endovascular treatment of acute typeB aortic dissection. Ann Thorac Surg2008;86(5):1707-12.
19Song TK, Donayre CE, Walot I, Kopchok GE, Litwinski RA, Lippmann M,et al. Endograft exclusion of acute and chronic descending thoracic aorticdissections. J Vasc Surg2006;43(2):247-58.
20Desai ND, Pochettino A, Szeto WY, Moser GW, Moeller PJ, Sodhi N,Jackson B, Woo E, Fairman RM, Bavaria J. Thoracic endovascular aorticrepair: evolution of therapy, patterns of use, and results in a10-yearexperience. J Thorac Cardiovasc Surg.2011Sep;142(3):587-94.
21Parsa CJ, Williams JB, Bhattacharya SD, Wolfe WG, Daneshmand MA,McCann RL, Hughes GC. Midterm results with thoracic endovascular aorticrepair for chronic type B aortic dissection with associated aneurysm. JThorac Cardiovasc Surg.2011Feb;141(2):322-7.
22Kusagawa H, Shimono T, Ishida M, Suzuki T, Yasuda F, Yuasa U, et al.Changes in false lumen after transluminal stent-graft placement in aorticdissections: six years’ experience. Circulation2005;111(22):2951-7.
23Sayer D, Bratby M, Brooks M, Loftus I, Morgan R, Thompson M. Aorticmorphology following endovascular repair of acute and chronic type B aorticdissection: implications for management. Eur J Vasc Endovasc Surg2008;36(5):522-9.
24Resch TA, Delle M, Falkenberg M, Ivancev K, Konrad P, Larzon T, et al.Remodeling of the thoracic aorta after stent grafting of type B dissection: aSwedish multicenter study. J Cardiovasc Surg2006;47(5):503-8.
25Rodriguez JA, Olsen DM, Lucas L, Wheatley G, Ramaiah V, DiethrichEB. Aortic remodeling after endografting of thoracoabdominal aorticdissection. J Vasc Surg2008;47(6):1188-94.
© 2004-2018 中国地质图书馆版权所有 京ICP备05064691号 京公网安备11010802017129号 地址：北京市海淀区学院路29号 邮编：100083 电话：办公室：(+86 10)66554848；文献借阅、咨询服务、科技查新：66554700 |