Busuttil S, Hall L, Hines G L
Department of Thoracic and Cardiovascular Surgery, Winthrop-University Hospital, Mineola, NY 11501.
Ann Vasc Surg. 1993 Sep;7(5):414-8. doi: 10.1007/BF02002124.
Spontaneous dissection of the infradiaphragmatic abdominal aorta is a rare form of aortic dissection. Its natural history and management are not well defined. We have recently treated five patients with spontaneous aortic dissection. Two patients had acute dissections and three had chronic dissections. Three patients developed saccular aneurysms and underwent resection. Two patients had stable dissections and were treated medically. All patients are alive and well at 6 months to 5 years. We think that spontaneous aortic dissection can be treated as a variant of type III dissection with initial medical management, reserving surgery for those patients in whom a saccular aneurysm or a complication of the dissection develops.
膈下腹主动脉自发性夹层是主动脉夹层的一种罕见形式。其自然病程和治疗方法尚不明确。我们最近治疗了5例自发性主动脉夹层患者。2例为急性夹层，3例为慢性夹层。3例患者出现囊状动脉瘤并接受了切除术。2例患者夹层病情稳定，接受了药物治疗。所有患者在6个月至5年时均存活且状况良好。我们认为，自发性主动脉夹层可作为III型夹层的一种变体，初始采用药物治疗，对于出现囊状动脉瘤或夹层并发症的患者则进行手术治疗。
