关键词: 主动脉夹层, 导丝抓捕器, 血管内膜破口, X线曝光时间

Abstract: Objective    To investigate and analysis the treatment of Guide wirecapture technique in the endovascular stent repair for Stanford B aortic dissection.Method  67 consecutive patients with complex Stanford B aortic dissection.Our patients cohort were divided into those applied with retrograde technique endovascular stent repair(group A,n=57) and anterograde Guide wirecapture technique(group B,n=10).Compared the general characteristics,true and false lumen diameter,Xray exposure time,total surgical time and analysis the correlation between intimal rupture number and Xray exposure time.Result  There was no significant difference in success rate between group A and B(85.1% vs 100.0%,P>0.05).The intimal rupture number(Group A:1.9±0.8,Group B:3.4±0.8,P<0.05）,tissue or organ poor perfusion case of group B(60.0%) was higher than that of group A(15.8%,P<0.05).The false lumen diameter of group B[（29.6±9.1）mm] was wider than that of group A[（21.7±7.4）mm,P<0.05)].3 patients of group A suffer from the left upper limb poor perfusion syndrome and conducted with rightleft axillary artery bypass.1 patient of group B suffered reversely tore after operation and progressed to A type aortic dissection,then conducted with Sun’ surgery and been completely reversed.The operation time and Xray exposure time of group B[（174.2±26.2）min and（522.9±67.4）s] was longer than that of groupA[（147.8±22.6）min and（267.1±29.1）s,P<0.05)].We conclude that the Xray exposure time may positively correlated with the intimal rupture number(R2=0.47,95%CI： 0.1051～0.9197,P<0.05).In most cases,followup was maintained and no obvious leakage occurred. Conclusion  We concluded that the increased intimal rupture number may increase the degree of surgical difficulty and the Xray exposure time.Guide wirecapture technique in the endovascular stent repair for complicated Stanford B aortic dissection  may be a safe  and reliable manner.

Key words: aortic dissection, guide wirecapture technique, intimal rupture, 〓ray exposure time