Terapijske mogućnosti kod komplikacija disekcije aorte ''Stanford B''

master's thesis

• Title (english): Treatment possibilities for complications of aortic dissection ''Stanford type B''
• Author: Mateja Anđić
• Mentor: Mladen Petrunić (mentor)
• Committee member: Tomislav Luetić (predsjednik povjerenstva)
• Committee member: Tomislav Meštrović (član povjerenstva)
• Committee member: Mladen Petrunić (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Surgery); Zagreb
• Defense date and country: 2015-07-15, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Surgery

Abstract

Odabir najbolje metode kod liječenja kompliciranih disekcija aorte predstavlja izazov suvremenoj medicini. Pregledni rad pod naslovom „Terapijske mogućnosti kod komplikacija disekcije aorte Stanford B“, autorice Mateje Anđić, studentice Medicinskog fakulteta Sveučilišta u Zagrebu, nastoji objediniti te metode na jednom mjestu te razmotriti njihove prednosti i nedostatke.
Akutnu disekciju aorte klasificiramo prema Stanfordu na tip A i B, koji mogu biti sa ili bez komplikacija. Prema istraživanjima, incidencija akutne disekcije aorte iznosi 2,9 do 3,5 na 100000 i postoje faktori rizika, poput hipertenzije ili strukturnih abnormalnosti aorte koji predisponiraju nastanak tog stanja. Pacijenti koji imaju disekciju se mogu prezentirati s različitom kliničkom slikom. Međutim, uglavnom se pojavljuju simptomi poput boli, sinkope, hipertenzije te ovisno o tome koji dio aorte ili njenog ogranka jest zahvaćen, neurološki simptomi i simptomi ishemije organa. Iako je u dijagnostici dostupan širok spektar pretraga, disekcija se uglavnom dijagnosticira na temelju prikaza CT snimki, što zbog visoke osjetljivosti i specifičnosti navedene metode, što zbog njene dostupnosti. Kada je riječ o terapijskim mogućnostima komplikacija disekcije tu u obzir dolaze klasične kirurške i endovaskularne metode. Obzirom da otvorena operacija sa sobom nosi visoku stopu mortaliteta, sve se više istražuju druge metode liječenja. Tako se danas endovaskularnim pristupom radi fenestracija i implantacija stenta u zahvaćeni dio aorte. Također se koriste i stent graftovi, jer sprječavaju nastanak kasnije aneurizmatske dilatacije i moguće rupture. Odabir metode ovisit će o mogućnostima centra u kojem se to radi, vještini operatera i individualnom stanju pacijenta.

Abstract (english)

Choice of the best method for treating complicated aortic dissection represents challenge for modern medicine. Review article „Treatment possibilities for complications of aortic dissection Stanford type B“, written by Mateja Anđić, medical student at the University of Zagreb, intends to summarize these methods at one place and see which are their advantages and disadvantages. Acute aortic dissection is classified according to Stanford as type A and B, and both types can be with or without complications. Population-based studies have estimated the incidence of acute aortic dissection to range from 2.9 to 3.5 per 100,000 person-years.The risk factors that can lead to development of dissection are hypertension or structural abnormalities of the aortic wall. Clinical presentation of these patients can be different, but most common presenting symptoms are pain, syncope, hypertension and, depending on which part of aorta or its branches is involved, neurologic symptoms and symptoms of organ ischemia. Although there are many possibilites to diagnose acute aortic dissection, CT is usually used for this purpose, because of its high sensitivity, specificity and availability. Considering treatment possibilities of complications of aortic dissection, we can divide them in classic surgical methods and endovascular methods. Because of significant mortality rate in open surgery, less invasive alternatives are also used. Today is performed endovascular fenestration and stenting and endovascular stent graft therapy. Which method will be chosen depends on possibilities of the center in which this procedure is performed, skills of surgent and individual patients state.

• Keywords: komplikacija; disekcije aorte „Stanford B“
• Keywords (english): complications; aortic dissection "Stanford type B"
• Language: croatian
• URN:NBN: urn:nbn:hr:105:123164
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2016-08-08 10:01:21