Home > Riviste > Italian Journal of Vascular and Endovascular Surgery > Fascicoli precedenti > Italian Journal of Vascular and Endovascular Surgery 2017 September;24(3) > Italian Journal of Vascular and Endovascular Surgery 2017 September;24(3):118-26

ULTIMO FASCICOLO
 

JOURNAL TOOLS

eTOC
Per abbonarsi
Sottometti un articolo
Segnala alla tua biblioteca
 

ARTICLE TOOLS

Publication history
Estratti
Permessi
Per citare questo articolo

 

REVIEW   

Italian Journal of Vascular and Endovascular Surgery 2017 September;24(3):118-26

DOI: 10.23736/S1824-4777.17.01297-9

Copyright © 2017 EDIZIONI MINERVA MEDICA

lingua: Inglese

New developments in the treatment of type B aortic dissection

Andreas MITSIS, Xun YUAN, Esther CAMBRONERO-CORTINAS, Christoph A. NIENABER

Cardiology and Aortic Center, Royal Brompton and Harefield NHS Trust, Imperial College, London, UK


PDF


Aortic dissection is an uncommon but a highly lethal condition. The management of type B dissection remains a clinical challenge with a variety of options. Thoracic endovascular aortic repair (TEVAR), aiming for true lumen reconstruction is a well-established treatment of choice for complicated type B aortic dissection. In so-called uncomplicated acute type B aortic dissection, the total diameter of the descending aorta (>45 mm), the large entry in a proximal site, any early expansion of the false lumen, evidence of partial thrombosis of the false lumen, probably a correlate of inflammation on position emission tomography (PET) scanning and high-volume flow in the false lumen on four-dimensional magnetic resonance imaging (4D MRI) are independent high-risk prognostic factors for aortic events; presence of any of these features identify a given clinically asymptomatic patient at high risk. Thus, these patients with high-risk features of type B aortic dissection should be considered for prophylactic and pre-emptive intervention with TEVAR within a 3-month window of “plasticity.” Patients without those high-risk features need very close surveillance and treatment as soon as high-risk criteria are identified during follow-up.


KEY WORDS: Aortic aneurysm - Risk assessment - Vascular grafting - Thrombosis

inizio pagina