关键词: Stanford B型主动脉夹层, 〓迷走右锁骨下动脉, 〓腔内治疗, 〓个体化治疗

Abstract: Objective：To elucidate the application of individual thoracic endovascular aortic repair(TEVAR)strategy in Stanford type B aortic dissection with an aberrant right subclavian artery(ARSA).Methods：Type B aortic dissection patients with ARSA were studied.An individual TEVAR strategy was made according to the distance between primary entry tear and ARSA and left subclavian artery(LSA),and left or right vertebral artery predominance type.Results：Twelve cases were enlisted in this study.Individual TEVAR strategy included:two cases of simple TEVAR,two cases of TEVAR+LSA fenestration,four cases of TEVAR+ single branched stent graft for LSA,one case of TEVAR+ARSA fenestration,one case of TEVAR+ hybrid operation(left carotid artery to LSA bypass),two cases of TEVAR+ open chest hybrid operation(ascending aorta to ARSA bypass in one patient,and ascending aorta to LSA and ARSA bypass in the other).During perioperative period,no retrograde dissection of ascending aorta,or neurologic complication,or paraplegia was recorded.During one year follow up,a mild type I endoleak was noted in one patient with ARAS fenestration,and remained stable.No other aortarelated or neurologic complication was recorded.LSA and ARSA with fenestration or branched stent graft remained patent.No death was noted during one year follow up.〖WTHZ〗Conclusion〓〖WTBZ〗Individual TEVAR strategy is a safe and effective technique in management of type B aortic dissection with ARSA.However,further largescale followup studies are required to verify its longterm efficacy.

Key words: stanford type B aortic dissection, 〓aberrant right subclavian artery, 〓intracavitary therapy, 〓individual management