近心端假腔血栓形成Stanford B 型主动脉夹层的治疗

目的：探讨近心端假腔内血栓形成的急性Stanford B型主动脉夹层患者的影像学特点、成因及治疗方法。方法：回顾性分析2010年1月—2012年10月郑州大学第一附属医院血管与腔内血管外科6例经64排以上全主动脉CTA确诊为近心端假腔内血栓形成的急性Stanford B型主动脉夹层患者的临床资料及随访资料。结果：6例患者均药物保守治疗2~4周出院，随访半年至2年，动态复查CTA显示假腔内血栓由上而下逐渐形成并逐渐吸收。结论：近心端假腔内血栓形成的急性Stanford B主动脉夹层处于血流动力学的稳定期，无须行主动脉腔内隔绝术（EVER），在长期严密影像学随访下的药物保守治疗是此类疾病的首选治疗方式。

Management of Stanford type B aortic dissection with proximal false lumen thrombosis

Objective: To investigate the imaging characteristics, causes and treatment of Stanford type B acute aortic dissection with proximal false lumen thrombosis. Methods: A retrospective analysis of clinical and follow-up data was performed in 6 patients, who were admitted between January 2010 and October 2012 in the department of vascular and endovascular surgery of the first affiliated hospital of Zhengzhou university, and diagnosed as Stanford type B acute aortic dissection with thrombus formation in the proximal false lumen that was confirmed by CT angiography over 64 slices. Results: All the 6 patients were discharged from hospital after 2- to 4-week conservative medical treatment. Dynamic CTA review, during the follow-up period of 6 months to 2 years, showed that the thrombi in the false lumen were gradually formed and gradually absorbed in a proximal to distal order. Conclusion: Stanford B acute aortic dissection with proximal false lumen thrombosis is in hemodynamically stable status and requires no performance of endovascular aortic repair (EVER). Conservative medical treatment is the first appropriate option for this condition under the premise of close follow-up with imaging assessment.