Therapy choice for Stanford type B aortic dissection / 中华普通外科杂志

ABSTRACT

Objective To summarize the mid-term result and clinical experience of individual treatment for Stanford type B aortic dissection.Method 213 patients (172 male,41 female) with Stanford type B aortic dissection were admitted between Apr 2008 and Jan 2013.Age ranged from 23 to 83 averaging 54 ± 9.63 patients were treated conservatively and 47 patients underwent open surgery,103 patients by endovascular repair.Result Patients in conservative group were older than those in open surgery group.Preoperative waiting time was the longest in open surgery group.Concomitant procedures adopted in open surgery group included replacement of ascending aorta and aortic arch in 3 patients and fenestration of stented elephant trunk in 19 patients; 31 patients received bypass graft of cervical vessels during endovascular repair.Mortality was 11.1％,4.3％,3.9％ in conservative group,open surgery group and endovascular group,respectively.Compared with open surgery,endovascular repair had a lower incidence of perioperative complications (P ＜ 0.05).186 patients were followed-up with a mean follow-up duration of (26± 17) months.There were no difference in mortality and complications between the three groups.Conclusions In Stanford B aortic dissection,individualized therapy based on patient's condition achieves a favorable mid-term result with low mortality and complication rate.