Comparison Of The Reconstruction Mode Of LSA On Type B Aortic Dissection With Insufficient Anchorage Zone

Objective: To study the follow-up of aortic dissection with insufficient anchorage zone, and investigate the prognostic value of different reconstruction mode of LSA, and explore the best therapeutic regimen of aortic dissection with insufficient anchorage zone.Materials and Methods: Collection of the data for the patients with Aortic Dissection with insufficient proximal anchorage zone, the patients in Tianjin Medical University General Hospital Vascular Surgery from January1, 2012 to December31, 2014. Research on grouping of reconstruction mode of LSA. Among the patients, partial or total occlusion of the Left subclavian artery in 11 cases, Chimney stent in 30 cases, Fenestrated stent-graft in 7 cases, Debranch hybrid surgery in 8 cases. Compare of the preoperative information, surgical effects and the incidence of postoperative complications between different groups. Evaluate the surgical techniques and prognosis.Results: 56 patients with insufficient anchorage zone in Tianjin Medical University General Hospital Vascular Surgery from January1, 2012 to December31, 2014 were enrolled in this study. There are no significant differences between the groups of preoperative information. Among the groups, post-operative severe complications in 9 cases, occlusion of the Left subclavian artery in 4 cases, Chimney stent in 3 cases, Fenestrated stent-graft in 1 cases, Debranch hybrid surgery in 1 cases. Post operation time of Debranch hybrid surgery is longer than other groups. There are no significant differences between the groups of the incidence of postoperative complications.Conclusion: It is secure and efficient to cover the Left subclavian artery after evaluate the Vertebral artery lesions of patients with Aortic Dissection with insufficient proximal anchorage zone. Chimney technique, Fenestrated stent-graft and Debranch surgery have definite effect for the treatment of Stanford type B aortic dissection with insufficient proximal anchorage zone. The incidence of postoperative leakage with Chimney Stent is higher than other groups. It is difficult to speculate the long-term follow up results. Because of the long post operation time, patients could choose the Hybrid surgery instead of the Interventional therapy. The operation of Fenestrated stent-graft with high difficulty, complex technology, short post operation time and fewer complications. It is an optimal therapy of Type B aortic dissection with insufficient anchorage zone.