Chimney Technology And Hybrid Technology Clinical Observation For The Treatment Of Type B Aortic Dissection

Objection:Through the chimney stent technology and hybrid flow technology postoperative cases retrospective study.Evaluate the efficacy of the two kinds of surgical operation,hospitalization duration,postoperative complications happening,reconstruction of vascular patency and survival quality evaluation indicators.Explore the pros and cons of different surgical technique for the complicated type B aortic dissection aorta branch blood vessels to provide evidence for the selection of treatment.Methods:This study collected in May 2015-June 2018 with chimney stent technology and hybrid to turn technology to handle complex flow B aortic dissection of the 76 patients,according to the different operation into the chimney and transferring group.The chimney group 36 cases,turn flow group 40 cases.Compared to two groups of patients hospitalized duration,preoperative and postoperative left/right upper limb artery systolic pressure,left subclavian artery,left subclavian artery bidirectional blood flow peak velocity,12 months left/right upper limb systolic pressure difference and left subclavian artery,left subclavian artery in the bidirectional blood flow peak velocity cases and follow-up data such as quality of life scores.According to the postoperative JinZhongQi appear leakage,voice hoarse,left upper limb ischemia symptoms,infection of incision,stent thrombosis,stent displacement and inverse tore sexual complications,such as type A aortic dissection research on two kinds of operation were retrospectively analyzed.Results:Two groups of cases successfully back ward,stable vital signs.The average hospitalization time is turn flow leader chimney group.Chimney group type I turn a flow set high incidence of leakage,boc has surgery intraaortic balloon expansion,artery stents and hemal wall joint is in good condition.Chimney group II leakage rate in the flow,in postoperative 1 month review aorta CTA of leakage has been closed by two groups of patients,the late follow-up has no leakage occurs.Chimney and transferring group are all in 1 patients with hoarseness and postoperative symptoms disappear after 1 month.Six months after a chimney group the transferring group high incidence of stent thrombosis,after should restore blood flow.Two groups of patients were no incision infection,left upper limb ischemia symptoms,inverse tear type A aortic dissection,stent displacement and other complications.Two groups of patients with postoperative left/right upper limb artery systolic blood pressure and left subclavian artery peak flow velocity and reconstruction of left subclavian artery opening effective flow area are affected by different degree,transferring patients postoperative less affected.Two groups of patients with postoperative quality of life were significantly improved,the quality of life has no obvious difference between groups.Conclusion:For complex type B for the treatment of dissection of aorta.Two groups of patients with reconstruction of the left subclavian artery flow decreases to some extent,hybrid transferring postoperative vascular stents in patients with unobstructed sex slightly better than a chimney.Although the chimney stent technology such as little trauma,less blood loss,postoperative quick recovery advantages is worth affirmation,but the bracket of leakage,the long-term patency rate and other issues have yet to be further research and improvement.When older patients,poor body condition,poor or emergency surgery,surgery tolerance can give preference to the chimney stent surgery.Hybrid operation on the wound,bleeding,operation difficulty is the chimney stents not advantage,but from long-term distal vascular patency rate and complication rates,hybrid flow technology is superior to the chimney support technology.