Rodiere Mathieu, Thony Frédéric, Michoud Marie, Frandon Julien, Ferretti Gilbert
CHU de Grenoble, Clinique universitaire de radiologie et d'imagerie médicale, 38043 Grenoble cedex 9, France.
Presse Med. 2011 Jan;40(1 Pt 1):54-61. doi: 10.1016/j.lpm.2010.11.006. Epub 2010 Dec 22.
Visceral malperfusion as a complication of aortic dissection represent 20 % of all type A or B aortic dissections. Visceral ischaemia is a factor of poor prognosis resulting in a higher mortality for these patients, yet, its clinical diagnosis is often underestimated. In all cases, the cross-sectional imaging, especially computed tomography, is needed to precise the mechanism of ischaemia. It allows differentiating dynamic from static ischaemia and thus to adapt its management. Endovascular treatment of ischaemia has been developed because it allows to a rapid treatment with a high success and low complication rates. Early results of aortic stentgrafting and aortic fenestration are up to 96 %, but late changes on the morphology or function reperfused gut was not studied.
内脏灌注不良作为主动脉夹层的一种并发症，在所有A型或B型主动脉夹层中占20%。内脏缺血是预后不良的一个因素，导致这些患者死亡率较高，然而，其临床诊断常常被低估。在所有病例中，都需要横断面成像，尤其是计算机断层扫描，以明确缺血机制。它能够区分动态缺血和静态缺血，从而调整治疗方案。缺血的血管内治疗已得到发展，因为它能实现快速治疗，成功率高且并发症发生率低。主动脉支架植入术和主动脉开窗术的早期结果高达96%，但未对再灌注肠道的形态或功能的晚期变化进行研究。
