Commentary: hybrid modifications to the aorta provide a more complete endovascular treatment for chronic dissection.

摘要

Chronic aortic dissection with aneurysmal degeneration is a complex problem to treat. The dissection often involves multiple segments of the aorta in patients with this disease, but the life-threatening aneurysmal degenerative process is usually limited to a shorter segment of the thoracic aorta. Arch involvement varies depending on whether the initial acute tear was a Stanford type A or B event. With either presentation, endovascular treatment is limited by both proximal and distal landing zone issues. The arch or proximal landing zone is commonly modified with the elephant trunk procedure if the tear is too close to the arch vessels, but little has been described to address issues at the distal landing zone.