Analysis The Clinical Effect Of Hybrid Technique Implement In Stanford Type B Aortic Dissection

BackgroundAortic dissection is the most dangerous and emergency cardiovascular disease. Since Dake and Nienaber repaired the thoracic aortic dissection with a stent graft successfully in 1999, the treatment of Stanford type B aortic dissection has gotten to a new endovascular era. With the technical proficiency and continuous application expansion, physicians are gradually pay more attention to the limits of its application. Especially for type B aortic dissection with complex lesion in aortic arch, Thoracic endovascular aortic repair (TEVAR) cannot solve all problems. Consequently, some of accessory techniques such as hybrid technique, chimney technique, fenestration,and branch stent-graft technique are gradually applied in this field. Currently, the most widely application is hybrid technique and chimney technique, also the advantages and disadvantages of both techniques need further discussion. We review retrospectively patients with hybrid technique performed in type B aortic dissections in our center and analysis the clinical effects of hybrid technique.ObjectiveTo study the clinical effects of hybrid technique performed in type B aortic dissections.MethodsOur study is retrospective analysis with the data collected from the interventional department of Henan Provincial People’s Hospital.Between January 2011 and December 2014, hybrid surgery was performed in 45 patients with a dissection involving the arch. Collected the clinical data in the period of hospitalization (including medical history, CTA data, DSA data),and postoperative follow-up data(the follow-up time is 3 to 46 months, collection the phone follow-up data or CTA data). To analysis the complications of perioperative period and follow-up, and to study the clinical effect of hybrid technique performed in type B aortic dissections.ResultsThe technical success rate was 100%. The average hospital stay was 20 days. A total of 8 cases(17.8%) suffered complications during hospitalization postoperative. Three strokes(6.6%) occurred, two cases(4.4%) died in perioperative period, one (2.2%) type II endoleak was identified, one(2.2%) pulmonary infection occurred, retrograde aortic arch dissection happened in one(2.2%) patient before leaving hospital, no spinal cord ischemia was identified. A total of 2 cases(4.8%) suffered complications during the follow-up:one (2.4%) prosthesis infection and one(2.4%) case died during the follow-up.ConclusionsThe complication of hybrid repair performed in type B aortic dissections is low. hybrid technique has a reasonable security and feasibility, but some of the serious complications should not be ignored. Long-term results are unknown, and larger series follow-up and comparative study should be taken to determine the safety and efficacy.