Abstract：Objective: To evaluate the efficacy of endovascular aortal repair(EVAR) and remodeling of aortic wall in patients with Stanford type B thoracic aortic dissection(AD). Methods: A total of 30 patients with Stanford type B AD who underwent EVAR were collected. A unified follow-up plan was made for all patients. CTA of the aorta was reviewed regularly at 1 month, 3 months, 6 months and 1 year after the operation to evaluate the changes of the aorta and postoperative complications. Results: In this study, 30 patients were successfully completed EVAR(100%), 21 males(70%), 9 females(30%), aged 36~68 years, the average age was (51.48±3.55) years, including AD 15 cases in acute phase(50%), 9 cases(30%) in subacute phase, 6 cases(20%) in chronic phase. The average follow-up time after EVAR was (17.31±4.28) months. One case died of aortic rupture within one year after operation, and two cases had internal leakage(1 case in type Ⅰ and 1 case in type Ⅱ). After the operation of AD, the aortic stent segment had the best absorption effect, followed by the distal thoracic aorta segment, and the abdominal aorta segment had the worst effect. Compared with AD patients in the acute and subacute phase, the absorption effect of AD patients in chronic phase was significantly decreased(P<0.05). In patients with AD at different stages after surgery, the true lumen diameter of the aorta was larger and the false lumen was smaller than that before surgery, and the difference was statistically significant(P<0.05). Compared with AD in the acute phase and subacute phase, the difference between the true lumen diameter and the false lumen diameter in the chronic phase was smaller. The maximum diameter of the vasculature after EVAR in the acute and subacute phase was smaller than that before EVAR, the difference was statistically significant(before operation in acute phase (3.32±0.19) cm, after operation (2.96±0.27) cm, P=0.00, P＜0.05; before operation in subacute phase (3.03±0.28) cm, after operation (2.88±0.37) cm, P=0.04, P<0.05), but the change of the aortic lumen diameter in the chronic phase was not statistically significant(before operation in chronic phase (4.15±0.53) cm, after operation (4.12±0.55) cm, P=0.95, P＞0.05). Conclusion: EVAR in the treatment of Stanford type B AD patients has a certain short-term and medium-term effect, promoting the remodeling of the aortic wall after AD surgery, but the effect of EVAR treatment in AD patients with different phases of aortic wall remodeling is different, the effect of aortic remodeling in chronic phase is the worst.
高新华，刘兆玉. Stanford B型胸主动脉夹层腔内修复术后的临床随访观察[J]. 中国临床医学影像杂志, 2020, 31(8): 534-537.
GAO Xin-hua, LIU Zhao-yu. Clinical follow-up study of Stanford type B thoracic aortic dissection with endovascular repair. JOURNAL OF CHINA MEDICAL IMAGING, 2020, 31(8): 534-537.
