Skip to main content
SpringerLink
Log in

Distale Aortendissektion Typ Stanford B

  • Chapter
  • First Online:
Evidenzbasierte Gefäßchirurgie

  • 2402 Accesses

Zusammenfassung

Die Leitlinien und Konsensus-Empfehlungen zur Behandlung der unkomplizierten und komplizierten akuten, subakuten und chronischen Aortendissektion Typ B werden dargestellt. Für die unkomplizierten Verlaufsformen wird primär die konservative Behandlung empfohlen, komplizierte Verläufe machen einen offenen chirurgischen Eingriff oder die endovaskuläre Behandlung mit einem Stentgraft erforderlich. Zwar fehlen randomisierte Studien, jedoch geben die Ergebnisse retrospektiver Fallserien und die Registererhebungen eindeutig dem endovaskulären Vorgehen vor dem offenen Eingriff den Vorzug.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 49.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Literatur

  • Andacheh ID, Donayre C, Othman F, Walot I, Kopchok G, White R (2012) Patient outcomes and thoracic aortic volume and morphologic changes following thoracic endovascular aortic repair in patients with complicated chronic type B aortic dissection. J Vasc Surg 56: 644–650

    Article  PubMed  Google Scholar 

  • Brunkwall J, Kasprzak P, Verhoeven E, Heijmen R, Taylor P; the ADSORB Trialists (2014) Endovascular repair of acute uncomplicated aortic type B dissection promotes aortic remodelling: 1 year results of the ADSORB trial. Eur J Vasc Endovasc Surg 48: 285–291

    Article  CAS  PubMed  Google Scholar 

  • Brunkwall J, Lammer J, Verhoeven E, Taylor P (2012) ADSORB: a study on the efficacy of endovascular grafting in uncomplicated acute dissection of the descending aorta. Eur J Vasc Endovasc Surg 44: 31–36

    Article  CAS  PubMed  Google Scholar 

  • Chou HP, Chang HT, Chen CK et al (2015) Outcome comparison between thoracic endovascular and open repair for type B aortic dissection: A population-based longitudinal study. J Chin Med Assoc 78: 241–248 jcma.2014.10.003. [Epub ahead of print]

    Google Scholar 

  • Conway AM, Sadek M, Lugo J, Pillai JB, Pellet Y, Panagopoulos G, Carroccio A, Plestis K (2014) Outcomes of open surgical repair for chronic type B aortic dissections. J Vasc Surg 59: 1217–1223

    Article  PubMed  Google Scholar 

  • Durham CA, Cambria RP, Wang LJ, Ergul EA, Aranson NJ, Patel VI, Conrad MF (2015) The natural history of medically managed acute type B aortic dissection. J Vasc Surg 61: 1192–1199

    Google Scholar 

  • Eckstein H-H, Knipfer E, Ockert S (2011) Aortendissektion Typ B. Definition, Pathogenese und Epidemiologie. Gefäßchirurgie 16: 552–556

    Google Scholar 

  • Fattori R, Cao P, De Rango P, Czerny M, Evangelista A, Nienaber C, Rousseau H, Schepens M (2013) Interdisciplinary expert consensus document on management of type B aortic dissection. J Am Coll Cardiol 61: 1661–1678

    Article  PubMed  Google Scholar 

  • Fattori R, Montgomery D, Lovato L, Kische S, Di Eusanio M, Ince H, Eagle KA, Isselbacher EM, Nienaber CA (2013) Survival after endovascular therapy in patients with type B aortic dissection: a report from the International Registry of Acute Aortic Dissection (IRAD). JACC Cardiovasc Interv 6: 876–882

    Article  PubMed  Google Scholar 

  • Grommes J, Greiner A, Bendermacher B et al (2014) Risk factors for mortality and failure of conservative treatment after aortic type B dissection. J Thorac Cardiovasc Surg 148: 2155–2160

    Article  PubMed  Google Scholar 

  • Hanna JM, Andersen ND, Ganapathi AM, McCann RL, Hughes GC (2014) Five-year results for endovascular repair of acute complicated type B aortic dissection. J Vasc Surg 59: 96–106

    Article  PubMed  Google Scholar 

  • Hiratzka LF, Bakris GL, Beckman JA et al (2010) 2010 ACCF/AHA/AATS/ACR/ASA/SCA/SCAI/SIR/STS/SVM guidelines for the diagnosis and management of patients with Thoracic Aortic Disease: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines, American Association for Thoracic Surgery, American College of Radiology, American Stroke Association, Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, Society of Interventional Radiology, Society of Thoracic Surgeons, and Society for Vascular Medicine. Circulation 121: e266–369

    Article  PubMed  Google Scholar 

  • Hogendoorn W, Hunink MG, Schlösser FJ, Moll FL, Sumpio BE, Muhs BE (2014) Endovascular vs. open repair of complicated acute type B aortic dissections. J Endovasc Ther 21: 503–514

    Article  PubMed  Google Scholar 

  • Howard DP, Banerjee A, Fairhead JF, Perkins J, Silver LE, Rothwell PM; Oxford Vascular Study (2013) Population-based study of incidence and outcome of acute aortic dissection and premorbid risk factor control: 10-year results from the Oxford Vascular Study. Circulation; 127: 2031–2037

    Article  PubMed  Google Scholar 

  • Jia X, Guo W, Li TX, Guan S, Yang RM, Liu XP, Zhang MH, Xiong J (2013) The results of stent graft versus medication therapy for chronic type B dissection. J Vasc Surg 57: 406–414

    Article  PubMed  Google Scholar 

  • Jones DW, Goodney PP, Nolan BW, Brooke BS, Fillinger MF, Powell RJ, Stone DH (2014) National trends in utilization, mortality, and survival after repair of type B aortic dissection in the Medicare population. J Vasc Surg 60: 11–19

    Article  PubMed Central  PubMed  Google Scholar 

  • Jonker FH, Trimarchi S, Rampoldi V et al.; International Registry of Acute Aortic Dissection (IRAD) Investigators (2012) Aortic expansion after acute type B aortic dissection. Ann Thorac Surg 94: 1223–1229

    Google Scholar 

  • Lombardi JV, Cambria RP, Nienaber CA, Chiesa R, Mossop P, Haulon S, Zhou Q, Jia F; STABLE investigators (2014) Aortic remodeling after endovascular treatment of complicated type B aortic dissection with the use of a composite device design. J Vasc Surg 59: 1544–1554

    Article  PubMed  Google Scholar 

  • Luebke T, Brunkwall J (2014) Cost-effectiveness of endovascular versus open repair of acute complicated type B aortic dissections. J Vasc Surg 59: 1247–1255

    Article  PubMed  Google Scholar 

  • Mani K Clough RE, Lyons OT, Bell RE, Carrell TW, Zayed HA, Waltham M, Taylor PR (2012) Predictors of outcome after endovascular repair for chronic type B dissection. Eur J Vasc Endovasc Surg 43: 386–391

    Article  PubMed  Google Scholar 

  • Midulla M, Renaud A, Martinelli T, Koussa M, Mounier-Vehier C, Prat A, Beregi JP (2011) Endovascular fenestration in aortic dissection with acute malperfusion syndrome: immediate and late follow-up. J Thorac Cardiovasc Surg 142: 66–72

    Article  PubMed  Google Scholar 

  • Minami T, Imoto K, Uchida K, Yasuda S, Sugiura T, Karube N, Suzuki S, Masuda M (2013) Clinical outcomes of emergency surgery for acute type B aortic dissection with rupture. Eur J Cardiothorac Surg 44: 360–364

    Article  PubMed  Google Scholar 

  • Mody PS, Wang Y, Geirsson A, Kim N, Desai MM, Gupta A, Dodson JA, Krumholz HM (2014) Trends in aortic dissection hospitalizations, interventions, and outcomes among medicare beneficiaries in the United States, 2000–2011. Circ Cardiovasc Qual Outcomes 7: 920–928

    Article  PubMed  Google Scholar 

  • Moulakakis KG, Mylonas SN, Dalainas I, Kakisis J, Kotsis T, Liapis CD (2014) Management of complicated and uncomplicated acute type B dissection. A systematic review and meta-analysis. Ann Cardiothorac Surg 3: 234–246

    PubMed Central  PubMed  Google Scholar 

  • Nienaber CA, Kische S, Rousseau H et al.; INSTEAD-XL trial (2013) Endovascular repair of type B aortic dissection: long-term results of the randomized investigation of stent grafts in aortic dissection trial. Circ Cardiovasc Interv 6: 407–416

    Google Scholar 

  • Parsa CJ, Williams JB, Bhattacharya SD, Wolfe WG, Daneshmand MA, McCann RL, Hughes GC (2011) Midterm results with thoracic endovascular aortic repair for chronic type B aortic dissection with associated aneurysm. J Thorac Cardiovasc Surg 141: 322–327

    Article  PubMed Central  PubMed  Google Scholar 

  • Patel HJ, Williams DM, Meerkov M, Dasika NL, Upchurch GR Jr, Deeb GM (2009) Long-term results of percutaneous management of malperfusion in acute type B aortic dissection: implications for thoracic aortic endovascular repair. J Thorac Cardiovasc Surg 138: 300–308

    Article  PubMed  Google Scholar 

  • Ramdass M (2015) TEVAR for symptomatic Stanford B dissection: a systematic review of 30-day mortality and morbidity. Thorac Cardiovasc Surg 63: 97–112

    Google Scholar 

  • Sachs T, Pomposelli F, Hagberg R, Hamdan A, Wyers M, Giles K, Schermerhorn M (2010) Open and endovascular repair of type B aortic dissection in the Nationwide Inpatient Sample. J Vasc Surg 52: 860–866

    Article  PubMed  Google Scholar 

  • Shah TR, Rockman CB, Adelman MA, Maldonado TS, Veith FJ, Mussa FF (2014) Nationwide comparative impact of thoracic endovascular aortic repair of acute uncomplicated type B aortic dissections. Vasc Endovascular Surg 48: 230–233

    Article  PubMed  Google Scholar 

  • Steuer J, Eriksson MO, Nyman R, Björck M, Wanhainen A (2011) Early and long-term outcome after thoracic endovascular aortic repair (TEVAR) for acute complicated type B aortic dissection. Eur J Vasc Endovasc Surg; 41: 318–323

    Article  CAS  PubMed  Google Scholar 

  • Svensson LG, Kouchoukos NT, Miller DC et al; Society of Thoracic Surgeons Endovascular Surgery Task Force (2008) Expert consensus document on the treatment of descending thoracic aortic disease using endovascular stent-grafts. Ann Thorac Surg 85: S1–41.

    Google Scholar 

  • Thrumurthy SG, Karthikesalingam A, Patterson BO, Holt PJ, Hinchliffe RJ, Loftus IM, Thompson MM (2011) A systematic review of mid-term outcomes of thoracic endovascular repair (TEVAR) of chronic type B aortic dissection. Eur J Vasc Endovasc Surg; 42: 632–647

    Article  CAS  PubMed  Google Scholar 

  • Tian DH, De Silva RP, Wang T, Yan TD (2014) Open surgical repair for chronic type B aortic dissection: a systematic review. Ann Cardiothorac Surg 3: 340–350

    PubMed Central  PubMed  Google Scholar 

  • Trimarchi S, Jonker FH, Muhs BE, Grassi V, Righini P, Upchurch GR, Rampoldi V (2010) Long-term outcomes of surgical aortic fenestration for complicated acute type B aortic dissections. J Vasc Surg 52: 261–266

    Article  PubMed  Google Scholar 

  • Trimarchi S, Tolenaar JL, Tsai TT et al (2012) Influence of clinical presentation on the outcome of acute B aortic dissection: evidences from IRAD. J Cardiovasc Surg (Torino) 53: 161–168

    CAS  Google Scholar 

  • van Bogerijen GH, Tolenaar JL, Rampoldi V, Moll FL, van Herwaarden JA, Jonker FH, Eagle KA, Trimarchi S (2014) Predictors of aortic growth in uncomplicated type B aortic dissection. J Vasc Surg 59: 1134–1143

    Article  PubMed  Google Scholar 

  • VIRTUE Registry Investigators (2014) Mid-term outcomes and aortic remodelling after thoracic endovascular repair for acute, subacute, and chronic aortic dissection: The VIRTUE Registry. Eur J Vasc Endovasc Surg 48: 363–371

    Article  Google Scholar 

  • Wiedemann D, Ehrlich M, Amabile P, Lovato L, Rousseau H, Evangelista-Masip A, Moeller P, Bavaria J (2014) Emergency endovascular stent grafting in acute complicated type B dissection. J Vasc Surg 60: 1204–1208

    Article  PubMed  Google Scholar 

  • Wilkinson DA, Patel HJ, Williams DM, Dasika NL, Deeb GM (2013) Early open and endovascular thoracic aortic repair for complicated type B aortic dissection. Ann Thorac Surg 96: 23–30

    Article  PubMed  Google Scholar 

  • Zoli S, Etz CD, Roder F, Mueller CS, Brenner RM, Bodian CA, Di Luozzo G, Griepp RB (2010) Long-term survival after open repair of chronic distal aortic dissection. Ann Thorac Surg; 89: 1458–1466

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Klinik und Poliklinik für Gefäßmedizin, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland

    E. Sebastian Debus

  2. ehem. Wissenschaftlich Medizinischer Direktor Kreiskliniken Altötting-Burghausen, Burghausen, Deutschland

    Reinhart T. Grundmann

Authors
  1. E. Sebastian Debus
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Reinhart T. Grundmann
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to E. Sebastian Debus .

Rights and permissions

Reprints and permissions

Copyright information

© 2015 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

Debus, E., Grundmann, R. (2015). Distale Aortendissektion Typ Stanford B. In: Evidenzbasierte Gefäßchirurgie. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-47167-8_2

Download citation

  • DOI: https://doi.org/10.1007/978-3-662-47167-8_2

  • Published:

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-662-47166-1

  • Online ISBN: 978-3-662-47167-8

  • eBook Packages: Medicine (German Language)

Publish with us

Policies and ethics

Search

Navigation