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[胸主动脉的急慢性病变:从诊断到治疗]

[Acute and chronic pathologies of the thoracic aorta: From diagnosis to treatment].

作者信息

Sadate Alexandre, Frandon Julien, Goupil Jean, Picard Eric, Cayla Guillaume, Branchereau Pascal, Beregi Jean-Paul

机构信息

CHU de Nîmes, université Montpellier, radiologie et imagerie médicale, 30029 Nîmes, France.

CHU de Nîmes, université Montpellier, chirurgie vasculaire, 30029 Nîmes, France.

出版信息

Presse Med. 2019 Jun;48(6):706-713. doi: 10.1016/j.lpm.2019.05.003. Epub 2019 May 28.

Abstract

Aortic pathologies benefit from imaging innovation and interventional radiology developments in order to improve patient management. At the early phase, vital risk should be considered. Whole body CT scan evaluate the complete aorta and its branches to assess the pathology and to choose the best approach between surgery or interventional radiology (fenestration, stentgraft, peripheral stenting). Algorithms, based on the understanding of the complications mechanisms and evolutive risk, modified the management specifically for aortic dissection. At chronic phase, GPs and angiologists should follow their patients in order to detect aortic complications and to treat cardiovascular risk factors. MRA is well indicated if possible.

摘要

主动脉病变受益于影像学创新和介入放射学的发展,以改善患者管理。在早期阶段,应考虑生命风险。全身CT扫描可评估整个主动脉及其分支,以评估病变情况,并在手术或介入放射学(开窗术、覆膜支架置入术、外周支架置入术)之间选择最佳治疗方法。基于对并发症机制和演变风险的理解而制定的算法,专门修改了主动脉夹层的治疗方案。在慢性期,全科医生和血管病专家应随访患者,以检测主动脉并发症并治疗心血管危险因素。如有可能,磁共振血管造影(MRA)是很好的检查方法。

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