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Erschienen in:

15.04.2024 | Aortendissektion | CME

Stanford-Typ-B-Dissektion

Epidemiologie, Diagnostik und Therapie

verfasst von: Dr. med. Matthias Niklas Hagedorn, Katrin Meisenbacher, Philipp Erhart, Moritz Sebastian Bischoff, Dittmar Böckler

Erschienen in: Gefässchirurgie | Ausgabe 4/2024

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Zusammenfassung

Die diagnostischen und therapeutischen Möglichkeiten im Kontext der Aortendissektion Typ Stanford B (TBAD) haben sich im Verlauf der letzten 3 Jahrzehnte weiterentwickelt. Bei Patienten unter 40 Jahren sollte eine genetische Abklärung erfolgen, um Bindegewebserkrankungen auszuschließen. Der Goldstandard für die Diagnostik und Planung der Therapie von TBAD ist die EKG-getriggerte Dünnschicht-CTA (Computertomograpie-Angiographie). Akut komplizierte Dissektionen sollten notfallmäßig endovaskulär versorgt werden. Dabei können zusätzlich zur thorakalen endovaskulären Aortenreparatur (TEVAR) andere Prozeduren wie z. B. PETTICOAT („provisional extension to induce complete attachment“) oder Membranfenestrationen zum Einsatz kommen. Auch Patienten mit unkomplizierten Dissektionen scheinen im subakuten Intervall bei Vorliegen von Prädiktoren einer Progression von einer endovaskulären Therapie zu profitieren. Unabhängig vom initialen Therapieregime benötigen die Patienten eine lebenslange Nachsorge. Patienten mit einer TBAD sollten in ein Aortenzentrum verlegt werden.
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Zurück zum Zitat Czerny M, Rylski B, Morlock J et al (2018) Orthotopic branched endovascular aortic arch repair in patients who cannot undergo classical surgery. Eur J Cardiothorac Surg 53:1007–1012PubMed Czerny M, Rylski B, Morlock J et al (2018) Orthotopic branched endovascular aortic arch repair in patients who cannot undergo classical surgery. Eur J Cardiothorac Surg 53:1007–1012PubMed
Metadaten
Titel
Stanford-Typ-B-Dissektion
Epidemiologie, Diagnostik und Therapie
verfasst von
Dr. med. Matthias Niklas Hagedorn
Katrin Meisenbacher
Philipp Erhart
Moritz Sebastian Bischoff
Dittmar Böckler
Publikationsdatum
15.04.2024
Verlag
Springer Medizin
Erschienen in
Gefässchirurgie / Ausgabe 4/2024
Print ISSN: 0948-7034
Elektronische ISSN: 1434-3932
DOI
https://doi.org/10.1007/s00772-024-01097-6

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