Hunter J A, Dye W S, Javid H, Najafi H, Goldin M D, Serry C
Arch Surg. 1976 Nov;111(11):1258-62. doi: 10.1001/archsurg.1976.01360290092014.
Dissection nearly always begins in the thorax, but it commonly extends into the abdominal aorta, which may become the focal point of the disease. We report five patients who illustrate the surgical management of this disease variant. Clinical manifestations included retroperitoneal rupture, expanding false aneurysm, and lower aortic occlusion. All patients had an aortic bifurcation graft, with reentry of the false lumen at the renal level. Two patients also had thoracic-aortic resection or plasty or both. Although one patient had thoracic aortic rupture at the five-year interval, these abdominal aortic resections provided effective palliation in all. This successful experience in managing complex dissections shows that when aortic dissection extends into the abdomen, resection of the distal aorta with a reentry procedure may be appropriate therapy.
解剖几乎总是始于胸部，但通常会延伸至腹主动脉，腹主动脉可能会成为该病的病灶。我们报告了5例患者，以说明这种疾病变体的手术治疗方法。临床表现包括腹膜后破裂、假性动脉瘤扩大和低位主动脉闭塞。所有患者均接受了主动脉分叉移植术，在肾水平处有假腔再入。2例患者还接受了胸主动脉切除术或成形术或两者皆有。尽管1例患者在5年时出现胸主动脉破裂，但这些腹主动脉切除术均提供了有效的姑息治疗。在处理复杂夹层方面的这一成功经验表明，当主动脉夹层延伸至腹部时，采用再入手术切除远端主动脉可能是合适的治疗方法。
