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胸主动脉腔内修复术在慢性 B 型主动脉夹层中的作用。

The Role of Thoracic Endovascular Repair in Chronic Type B Aortic Dissection.

机构信息

Division of Cardiothoracic Surgery, University of Washington, Seattle, Washington.

Division of Cardiothoracic Surgery, University of Pennsylvania, Philadelphia, Pennsylvania.

出版信息

Semin Thorac Cardiovasc Surg. 2020;32(1):21-24. doi: 10.1053/j.semtcvs.2019.08.010. Epub 2019 Sep 4.

Abstract

Continued device improvements along with refined implantation techniques have revolutionize the use of thoracic endovascular repair for both aortic dissections and aneurysms. This is now considered standard of care for acute, complicated type B aortic dissection in patients with appropriate anatomy. However, the treatment of chronic, uncomplicated type B dissection continues to present challenges for the aortic surgeon, as the long-held dogma of medical management and surveillance for aneurysm degeneration has recently come into questions. We present evidence for a more thoughtful approach to management and intervention with thoracic endovascular repair in select patients with chronic, type B dissection.

摘要

随着器械的不断改进和植入技术的精细化,胸主动脉腔内修复术在治疗主动脉夹层和动脉瘤方面得到了革命性的发展。对于解剖结构合适的急性、复杂型 B 型主动脉夹层患者,该技术现在已被视为标准治疗方法。然而,对于慢性、不复杂型 B 型夹层患者,主动脉外科医生仍然面临着挑战,因为长期以来的治疗原则——对动脉瘤退行性变进行药物治疗和监测——最近受到了质疑。我们提出了一种更具策略性的方法,即选择性地对慢性 B 型夹层患者进行胸主动脉腔内修复术治疗和干预。

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