Arts Cora H P, Verhagen Hence J M, Heyligers Jan M M, Moll Frans L
Universitair Medisch Centrum Utrecht, Afd. Heelkunde, Utrecht, The Netherlands.
Ned Tijdschr Geneeskd. 2010;154:B460.
Four patients presented with an acute type B aortic dissection. All were managed medically. However, three of the four patients needed additional invasive treatment. A 67-year-old patient was given a spinal catheter because of neurological symptoms. A 57-year-old patient underwent endovascular fenestration of the right renal artery and stenting of the iliac arteries to treat acute ischemia. In a 71-year-old patient an endograft was placed in the distal aortic arch to close a tear in the aortic wall, and two stents were placed in the right renal artery for stenosis. Currently, medical management is the preferred treatment for uncomplicated type B aortic dissection. In complicated type B aortic dissection, endovascular grafting seems to be a useful solution with a high primary success percentage.
4例患者表现为急性B型主动脉夹层。所有患者均接受药物治疗。然而，4例患者中有3例需要额外的侵入性治疗。一名67岁患者因神经症状置入了脊髓导管。一名57岁患者接受了右肾动脉血管内开窗术和髂动脉支架置入术以治疗急性缺血。一名71岁患者在主动脉弓远端置入了腔内移植物以封闭主动脉壁的撕裂口，并在右肾动脉置入了两枚支架以治疗狭窄。目前，药物治疗是单纯B型主动脉夹层的首选治疗方法。在复杂B型主动脉夹层中，血管内植入术似乎是一种有效的解决方案，初次成功率较高。
