Indication, Timing and Results of Endovascular Treatment of Type B Dissection
Indication, Timing and Results of Endovascular Treatment of Type B Dissection
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DOI：
10.1016/j.ejvs.2008.12.004
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发表时间：
2009-03-01
影响因子：
5.7
通讯作者：
Nienaber, C. A.
中科院分区：
文献类型：
--
作者：
Akin, I.;Kische, S.;Nienaber, C. A.
Aortic dissection is an uncommon but a highly lethal condition. Dissection of the ascending aorta is associated with a mortality rate of 1-2% per hour within the first 24 h and should be managed by an open surgery. An uncomplicated, acute, type B dissection, which should be treated medically, is less frequently lethal, with survival rates of 84% within 1 year. Unfortunately, long-term outcome of medical therapy alone is suboptimal, with a reported 30-50% mortality rate at 5 years and a delayed expansion of the false lumen in 20-50% of patients at 4 years. In this setting, endovascular treatment should be considered when the aortic diameter exceeds 55-60 mm, in case of uncontrolled pain, blood pressure and rapid growth of the dissecting aneurysm (>1 cm per year). About 30-42% of acute, type B aortic dissections are complicated, as evidenced by haemodynamic instability or peripheral vascular ischaemia with a mortality rate of 50-85% if not treated property. In this scenario, stent-graft repair is an attractive alternative to surgical repair for correcting ischaemic complications. The long-term therapy of patients with aortic dissection includes aggressive medical therapy, follow-up visits and serial imaging. (C) 2009 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.
