Lóc tách động mạch chủ ngực bán cấp nên đặt stent graft khi nào và thế nào

Subacute thoracic aortic dissection: When and how to perform TEVAR ? I-Hui Wu , MD, PhD Clinical Assistant Professor Division of Cardiovascular Surgery, Department of Surgery National Taiwan University Hospital, Taipei, Taiwan Aortic Dissections: special considerations Classification of aortic dissection Anatomic factors  Debakey  Standford Duration of symptoms  acute  chronic  subacute?? Complicated vs Uncomplicated Anatomic Classification Stanford Type A DeBakey Stanford Type B Classification Acute: < 14 days Chronic: >14 days Subacute: •led to renewed interest by the endovascular treatment •8-30 days? •15-30 days? •14-42 days? •15-90 days? JACC VOL 67, NO 10, 2016 MARCH 15,2016:1254–60 “Medical Therapy” for Acute Type B Aortic Dissections is not ideal • False lumen thrombosis • unpredictable • Long-term stabilization of septum • No assurance to prevent risk of dissection and rupture Estrera et al Circulation 2006; 114: I-384-389 • Jan 2001-March 2005 • 129 consecutive Type B dissections with initial medical management • Pt given B-blockers, calcium channel blockers, NTG, Nipride with goal of keeping SBP