Texas A&M College of Medicine, Bryan, Texas, US.
Baylor Scott and White Heart and Vascular Hospital, Dallas, Texas, US.
Methodist Debakey Cardiovasc J. 2023 Mar 7;19(2):59-69. doi: 10.14797/mdcvj.1171. eCollection 2023.
The purpose of this manuscript is to review recent trends in the management of acute type B aortic dissection. Due to its efficacy and low morbidity, thoracic endografting has rapidly been adopted as the treatment of choice for most patients with malperfusion or rupture as a consequence of acute aortic dissection. This technology is increasingly applied to patients without rupture or malperfusion, so-called "uncomplicated" dissections, to reduce the incidence of late aneurysmal degeneration in the ungrafted segments of the thoracoabdominal aorta. A variety of techniques have been proposed, including intentional rupture of the dissection membrane to obliterate the false lumen as well as the candy-plug technique to eliminate retrograde flow in the false lumen.
本文旨在综述急性 B 型主动脉夹层的治疗进展。腔内修复术由于疗效确切、并发症发生率低，已迅速成为大多数合并灌注不良或破裂的急性主动脉夹层患者的首选治疗方法。随着腔内修复术应用范围不断扩大，其适应证已从合并破裂或灌注不良的所谓“复杂型”夹层扩展至不合并破裂或灌注不良的“单纯型”夹层，以期降低胸主动脉-腹主动脉段未覆盖区域迟发性瘤样变的发生率。目前已提出多种技术，包括主动撕裂假腔以闭合真假腔之间的交通、“糖块填塞”技术以消除假腔逆行血流等。
