Choice Of The Treatment For Stable Standford B Type Aortic Dissection And Analysis Of Risk Factors For Aortic Dissection Death

Objective:To exlpore the treatment options for stable Standford B aortic dissection and analyse risk factors for the death in aortic dissection.Methods:The clinic informations of 53 patients(48 male and 5 femal, age from 39 to 75 with a mean age 54.2 years) with standford B type aortic dissection were retrospectively analyzed, from hepatobiliary Vascular Surgery department of First Affiliated Hospital of Guangxi Medical University. The effects of thoracic endovascular aortic repair(TEVAR) VS medical treatment alone for stable Standford B type aortic dissection were evaluated and the risk factors of death were analyzed.Results:The incidence of false lumen expansion and complications in the drug group was 42.9% and 50%, greater than 8.3% and 12.5% respectively in TEVAR group (P<0.05) in the treatment of stable Standford B type aortic dissection.The incidence of recurrent or persistent pain,malperfusion of important branches of aorta in the group of death was 66.7% and 44.4%, greater than 9.8% and 2.4% in the survival group (p<0.01). The mean maximal diameter aortic and blood pressure fluctuation in the death group was 58.2mm and 35.7mmHg, greater than 38.6mm and 20.6mmHg in the survival group (p <0.01).Conclusion:For treatment of stable standford B type aortic dissection, compared with medical treatment alone, TEVAR can significantly reduce the incidence of false lumen explanation and complications and is inclined to be used in stable standford B type aortic dissection with a patent fals lumen. Unstable blood pressure, aortic diameter> 5.0～6.0cm, malperfusion of important branches of aorta and recurrent or persistent pain are the risk factors for death in aortic dissection.