Osada Hiroaki, Minatoya Kenji
Department of Cardiovascular Surgery, Kyoto University, Kyoto, Japan.
Kyobu Geka. 2022 Sep;75(10):748-752.
Since a certain number of patients with Stanford type B acute aortic dissection have complications such as rupture and malperfusion (complicated type B), it is important to understand the pathogenesis of this condition and to avoid misjudging the timing and methods of invasive treatment such as thoracic endovascular aortic repair( TEVAR) and graft replacement. TEVAR is widely accepted as a less invasive treatment than conventional surgery, and is usually recognized as the first-line treatment, especially for complicated type B. On the other hand, there is still little clear evidence for TEVAR for uncomplicated type B without rupture or malperfusion, and careful selection of cases is considered necessary. In this review article, we describe the acute treatment of Stanford type B acute aortic dissection with reference to recent guidelines and literature.
由于一定数量的斯坦福B型急性主动脉夹层患者会出现破裂和灌注不良等并发症（复杂B型），了解这种疾病的发病机制并避免对诸如胸主动脉腔内修复术（TEVAR）和人工血管置换等侵入性治疗的时机和方法判断错误非常重要。与传统手术相比，TEVAR作为一种侵入性较小的治疗方法已被广泛接受，并且通常被认为是一线治疗方法，尤其是对于复杂B型。另一方面，对于没有破裂或灌注不良的非复杂B型患者，TEVAR的明确证据仍然很少，因此认为有必要仔细选择病例。在这篇综述文章中，我们参考最近的指南和文献描述了斯坦福B型急性主动脉夹层的急性治疗方法。
