Lupattelli Tommaso, Garaci Francesco Giuseppe, Basile Antonio, Casini Andrea, Dalainas Ilias, Minnella Daniela Paola, Iezzi Roberto
Department of Interventional Radiology, Multimedia irccs, Sesto San Giovanni, Milan, Italy.
Emerg Radiol. 2008 Nov;15(6):375-82. doi: 10.1007/s10140-008-0759-5. Epub 2008 Aug 28.
Type B aortic dissection is an uncommon yet potentially catastrophic clinical event that mandates prompt recognition and expeditious treatment. Patient survival depends on early and accurate diagnosis and prompt medical or surgical treatment. Unfortunately, when type B aortic dissection is associated with end-organ ischemia, medical treatment may not prove beneficial, with patients addressed to surgery; recently, either percutaneous fenestration or primary endovascular aortic repair has been proposed as a valuable alternative to surgery in this scenario. Although the ideal endograft has not emerged and improvement in the long-term behavior of the devices is required, endograft placement is becoming the first choice in patients with complicated type B aortic dissection requiring emergency treatment.
B型主动脉夹层是一种罕见但可能具有灾难性的临床事件,需要迅速识别并进行快速治疗。患者的生存取决于早期准确的诊断以及及时的药物或手术治疗。不幸的是,当B型主动脉夹层合并终末器官缺血时,药物治疗可能并无益处,这类患者需要接受手术治疗;最近,有人提出经皮开窗术或原发性血管内主动脉修复术可作为这种情况下手术的有效替代方案。尽管理想的血管内移植物尚未出现,且需要改善这些装置的长期性能,但对于需要紧急治疗的复杂B型主动脉夹层患者,血管内移植物置入正成为首选治疗方法。