Factors predictors de dilatació de l’aorta toràcica dissecada mitjançant la tomografia computada

摘要: La disseccio aortica s’associa a una mortalitat i morbilitat elevades. Tot que les complicacions produides durant la fase aguda condicionen l’evolucio mitja termini en certs pacients, majoria de casos presenten evolucio clinica acceptable els primers tres anys. Diverses tecniques d’imatge son capaces mostrar permeabilitat llum falsa l'aorta toracica descendent el 80% disseccions tipus A tractades amb cirurgia d’aorta ascendent 90% B no complicades medicament, un parametre afavoreix dilatacio l’aparicio cliniques llarg termini. series han estimat supervivencia global al cap deu anys es troba entre 20% 60%. Davant manca d’altres factors pronostics convincents del risc cliniques, s’ha proposat tractament endovascular preventiu tots permeable subaguda. Aquesta estrategia aplicable degut desconeixement relacio despesa beneficis morbimortalitat iatrogenica superi medic optimitzat. Per tant, resulta necessari identificar candidats intervencio quirurgica o subaguda disseccio. En aquest estudi 72 supervivents (tipus B) hem descrit validat internament metode permet classificar pacients grups per l’aorta dissecada d’esdeveniments aortics partir dos parametres obtinguts TC control detectar l’estrip proximal pero tambe distals mesurar llur area forma reproduible. presencia d’una diferencia superior 1 cm 2 arees dels estrips proximals definit com dominancia era potent factor pronostic aortics, incloent electiva aortes dissecades aneurismatiques. d’un calibre maxim igual 45 mm marca molt elevat seguiment. Addicionalment, deteccio taxa d’expansio mm/a als 3 excel?lent predictor final periode capacitat predictiva morfologics independent malaltia genetica aortica. seva combinacio permetia definir alt, intermedi baix incidencia simulacio sobre l’estudi, d’intervencio preventiva grup alt minimitzava necessitat terapia (14%), mentre seguiment (5%). ambdues estrategies, practicada intervinguts hauria detectat resta poblacio abans patir complicacio. Aortic dissection carries high mortality and morbidity. Although complications arising in the acute setting some patients mark their short mid term evolution, most cases have an clinical outcome during first three years. Several imaging techniques are able to show permeability of false lumen descending thoracic aorta surgically treated type medically aortic dissections. This favors dilatation occurrence long term. The overall survival rate has been estimated at about 60% ten years after syndrome. absence additional robust parameters predict expansion dissected incidence adverse events led proposal preventive treatment for all with patent subacute phase. strategy is currently not applicable due lack knowledge cost benefit ratio or iatrogenic risk repair this setting. Therefore, it necessary describe features identify which might from surgery phase dissection. In study chronic (both B), two obtained CT were classify into groups events. only detect both distal entry tears flap, but also measure areas reproducible way. Dominance between tears, defined as difference greater than was powerful prognostic events, including nonemergent intervention. presence maximum caliber equal marks followup. addition, / detected excellent end monitoring period. predictive capability morphological (type genetic disease. Their combination high, intermediate low simulation on patients, intervention group resulted while followup operated strategies, detection year performed would rest population before onset.