Krol Emilia, Panneton Jean M
Division of Vascular Surgery, Eastern Virginia Medical School, Norfolk, Virginia, USA.
Ann Vasc Dis. 2017 Sep 25;10(3):165-9. doi: 10.3400/avd.ra.17-00061.
Traditionally, the surgical management of acute type B aortic dissections was reserved for patients with signs of malperfusion, rapid expansion, retrograde dissection or rupture. The adjunct of endovascular techniques has brought a paradigm shift, leaning towards preventing long term dissection complications. Multiple risk factors have been proposed to identify patients at risk for long term aortic complications. The patients, who are offered a prophylactic endovascular therapy for uncomplicated aortic dissection, should be selected carefully, and offered intervention by an experienced team in a high-volume center. (This is a review article based on the invited lecture of the 57th Annual Meeting of Japanese College of Angiology.).
传统上,急性B型主动脉夹层的外科治疗仅适用于出现灌注不良、迅速扩展、逆行夹层或破裂迹象的患者。血管内技术的应用带来了范式转变,倾向于预防长期夹层并发症。已经提出了多种风险因素来识别有长期主动脉并发症风险的患者。对于单纯性主动脉夹层接受预防性血管内治疗的患者,应谨慎选择,并由经验丰富的团队在大容量中心进行干预。(本文是基于日本血管外科学会第57届年会特邀讲座撰写的综述文章。)