Author: Feng Jiaxun
Organization: Vascular Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine
Introduction
Feng Jiaxun discusses the complex nature of thoracoabdominal aortic dissections, which involve multiple anatomical and pathological challenges. The paper explores the indications for endoluminal treatments and the various surgical techniques that can be applied, including fenestration and branch reconstruction techniques, aiming to provide a comprehensive treatment perspective.
Treatment Indications and Strategies
• Indications for Endoluminal Treatment:
• Progressive aneurysmal dilation of the false lumen: Especially in patients with a dissection just past the initial tear site.
• Symptoms of visceral organ compression: For example, aortic expansion causing bile duct compression leading to jaundice.
• Rapid aneurysmal growth: An increase in the aneurysm’s diameter by more than 5mm in a short period.
• Dissection aneurysms forming arteriovenous fistulas: Such as renal artery fistulas.
• Treatment Strategies:
• Fenestration Techniques: Utilized to reconstruct visceral arteries ensuring unimpeded blood flow.
• Branch Reconstruction: Employed in cases of aortic/iliac artery dissection with aneurysmal dilation using branched grafts.
• Intraoperative Considerations: Factors such as the degree of aortic twisting and narrowing in the visceral segment.
Conclusion
The endoluminal treatment of thoracoabdominal aortic dissections offers a safe and effective method, particularly suitable for patients who are not ideal candidates for traditional open surgery. By choosing appropriate treatment indications and strategies, significant improvements in patient outcomes can be achieved.
References
1. Patterson B, et al. Circulation. 2013;127:24-32.
2. Kouchoukos NT, et al. JTCVS. 2018;155:1926-35.
Contact Us
Feel free to engage in more in-depth discussions and exchanges about the content related to the Tianfu Great Vessel Conference. For any questions or interests, please contact us via email at: endovascluar@simtomax.cn.
For more international information, visit:
• 网站: www.vascularknight.com
• Facebook: Vasco Knight
• Instagram: knight_vasco
Let’s collaborate for better health and showcase your expertise to the world!
