163 Cases Of Stanford B Aortic Dissection Analysis: A Clinical Research In Single Centre

Aim: Analysis parts of Stanford B aortic dissection patients admitted in our department between 2005 and 2009 retrospectively. Study the clinical traits and treatment method. Furthermore, compare the effect of medical treatment and endovascular repair.Result: Number of cases was 163. Male 138 cases(84.67%), female 25 cases(15.33%); the youngest was 24 year old, the oldest was 78 year old, mean age was (52.71±11.46) . Mean time in hospitalization was (20.23±10.42) days. Total mortality of hospitalization was 2.45% (4/163). Complications were impending rupture, uncontrollable hypertension, severe pleural effusion and respiratory failure, renal failure, ischemia of intestine, ischemia of lower extremity. 112 cases were administrated by intravenous anti-hypertension drugs. Mean days of using intravenous drug was (2.68±0.32).Oral anti-hypertensive drugs contained:β-blocker, calcium canal blocker, angiotonin-converting enzyme inhibitor , angiotonin receptor blocker , diuretics andα-blockers . 70 cases were treated by conservative treatment, time of reaching intending blood pressure was ( 2.99±0.32 ) days. The follow- up time was 1 month to 50 months. 93 cases were treated by endovascular repair, mean hospitalization time was (25.51±7.42) days, 34 cases were treated by endovascular repair in acute phase; 59 cases were treated in non-acute phase. The follow-up time was 1 month to 50 months. In endovascular repair group, 96 stent-graft were delivered. Cuffs were delivered in 7 cases. Balloons were used in 5 cases. LSA of 28 cases were covered by stent-grafts. 2 cases were used PDA excluder.Conclusion: Stanford B aortic dissection happened more frequently in 50 year old male people in our research. But female patients always have severe psychologic problems. This should be noticed clinically. The survival rate has significant deference between endovascular repair and medical treatment. Endovascular group is higher than medical treatment group. The dead hazard of patients who received medical treatment is 8.751 times higher than patients who received endovascular repair. The dead hazard of patients whose blood oxygen saturation high is 0.824 times higher than patients whose blood oxygen saturation lower. If the proximal landing zone is not enough, LSA can be covered safely in most cases. By-pass operation can solve the ischemia of brain and upper extremity. Type II endoleak from LSA can be solved by PDA excluder.