急性降主动脉夹层致器官灌注不良的诊疗进展

急性降主动脉夹层是致死性的主动脉疾病。治疗急性主动脉夹层的目标不仅是阻止动脉瘤的形成和破裂,而且要阻止灌注不良综合征这一类并发症的发生。尽管主动脉夹层伴灌注不良综合征的诊断有所提高,手术方式的选择有所改进,但外科手术治疗的病死率仍有50%。血管内治疗技术不断发展为主动脉夹层的治疗提供了一个新的选择。现回顾主动脉夹层伴灌注不良综合征的发病机制,讨论目前脊髓、小肠、肢体末梢灌注不足的治疗模式和各种治疗方法的疗效。

Progression of Management on Organ Malperfusion in Acute Descending Aortic Dissections

Acute descending aortic dissection is considered the most catastrophic event affecting the aorta. The therapeutic aim in trea- ting acute dissection is not only directed at the prevention of aneurysmal development and rupture but also to prevent and to treat complica- tions such as malperfusion syndromes. Despite an improvement in diagnosing dissections and malperfusion syndromes, and despite improved operative techniques,the surgical mortality rate can be as high as 50%. Endovascular techniques are constantly evolving that provide an aher- native to open procedures. The goal of this article was to review the pathogenesis of malperfusion syndromes in aortic dissection, discuss the current modalities to treat malperfusion of the spinal cord,viscera,and extremities,and examine the results of the treatments used today.