Stanford B型解離に対する外科治療の遠隔成績と予後因子の検討

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We studied the relation between prognostic factor and long-term results in regard to 43 cases of surgical treatment of Stanford type B dissection conducted from July 1987 through April 1999. Among the 43 cases, there were 4 cases of hospital death (9.3%) and 8 cases of late death (18.6%), and re-operation was performed for 5 cases (10.5%). The actuarial survival rate excluding the early stage death measured by Kaplan-Meier method was 90% in 5 years and 71% in 10 years. The rate of avoidance of all vascular events is 81% in 5 years and 62% in 10 years. Making analysis with Cox method proportional hazard model, there was significant difference only in the outer diameter of residual aneurysm (p=0.003) measured with CT after the operation in regard to all vascular events. In order to avoid vascular events, the operation technique which doesn't leave enlarged residual aneurysm (larger than 40 mm) and the operation which is performed at the period when the residual aneurysm is not left is desireable. In cases that the residual aneurysm exists, the staged operation should be elected.
東京女子医科大学の論文
2000-12-25