摘要Stanford B型主动脉夹层发病急、病情凶险.按治疗方式的不同,Stanford B型主动脉夹层可分为复杂性夹层和非复杂性夹层.对于复杂性夹层,推荐早期行主动脉腔内修复术(TEVAR);对于非复杂性夹层,既往的治疗方案是以药物治疗为主.但最新的循证医学证据表明,非复杂性夹层亦应早期行TEVAR治疗,可明显提高主动脉重塑率和远期生存率.对于手术时机选择,从主动脉可塑性时间窗和减少严重并发症两方面考虑,目前推荐在亚急性期(14～90 d)行TEVAR.非复杂性夹层治疗的另一关键点是发现需早期手术干预的患者.目前临床上可通过重点评估患者的影像学资料(如主动脉和假腔直径、真假腔状态、破口大小和数目等),结合患者的临床特征及实验室检查结果,筛选出需要早期TEVAR干预的高危非复杂性夹层患者.

abstractsStanford type B aortic dissection (TBAD) is an acute and life-threatening disease.The treatment of TBAD used to be depended on whether it is complicated.The therapeutic guidelines recommend thoracic endovascular aortic repair (TEVAR) as first-line treatment for patients with acute complicated TBAD,while recommend best medical therapy for patients with acute uncomplicated TBAD (UTBAD).However,the latest studies suggest that patients with UTBAD also should be treated with pre-emptive TEVAR,which can significantly improve aortic remodeling and clinical outcome.Considering improvement of aortic remodeling and prevention of severe complications,the best timing of pre-emptive TEVAR may be 14-90 days after the onset of TBAD (subacute phase).The other main issue is identifying which patients with UTBAD should undergo pre-emptive TEVAR.Several risk factors including imaging,clinical and laboratory parameters have been shown to be associated with aortic-related events in patients with UTBAD.Among imaging finding,the diameters of aortic or false lumen,the status of true or false lumen,the size or number of entry tears have identified to be as predictors of adverse aortic events in patients with UTBAD.