To explore the distribution characteristics and clinical typing methods in distal crevasses of Stanford B aortic dissection / 国际外科学杂志

Objective To explore the distribution characteristics and clinical typing methods in distal crevasses of Stanford B aortic dissection.Methods Review of the cases in the People's Hospital of Xinjiang Urgur Autonomous Region from 2010 January to 2013 June were diagnosis of Stanford type B aortic dissection with computed tomographic angiography data,Observed its distal crevasses distribution and statistical its number,then summarizes the distribution characteristics of the distal crevasses and further put forward a method of clinical typing.Results Refer to 115 cases with Stanford type B aortic dissection computed tomographic angiography data,including 101 cases with distal crevasses (87.83％) and a total of 240 distal crevasses,an average of 2.37 per case.Conclusions The distal crevasses more often appear in the area involving visceral artery,combined with its different in distribution characteristics and processing methods,we put forward the classification method,namely:Type Ⅰ:the distal crevasses are located in the zone of the thoracic artery; Type Ⅱ:the distal crevasses are close to the visceral artery or involvement it; Type Ⅲ:the distal crevasses are lower than the renal artery,not involving the visceral artery; Type Ⅳ:the distal crevasses are located in the zone of the iliac artery.

Comparative study for treatment principles of Stanford type B aortic dissection with distal crevasses / 国际外科学杂志

Objective To explore the treatment principle of distal crevasses in aortic dissection.Methods According to the different treatment principles of distal crevasses in aortic dissection to divide the patients into two groups:following the treatment principle group:take the principle of from near to far,endovascular repair of distal crevasses,if not deal with the crevasses involving visceral arteries,do not handle the distal crevasses; unfollowing the treatment principle group:do not deal with the crevasses involving visceral arteries,endovascular repair of it's distal crevasses).Analyze the postoperative discomfort (chest and back pain,lower back pain) incidence,postoperative distal crevasses happening again and false lumen changes respectively.Results Fifty-three patients were included in the standard,in which follow the treatment principle group has 37 cases,and do not follow the treatment principle group has 16 patients.There were no significance statistically in complained of postoperative discomfort and postoperative distal crevasses happening again(P ＞ 0.05).And there was statistically significant in the false lumen (P ＜ 0.05).Conclusions The prognosis of patients in the following the principle treatment is better than that of unfollowing the principle group.To treat the distal crevasses in aortic dissection should be took the principle of from near to far,if not deal with the crevasses involving visceral arteries,don't handle the distal crevasses also.