Medical and surgical treatment for patients with dissecting aneurysms of the aorta

The medical and surgical treatment of 96 patients of dissecting aneurysms was reviewed. There were 42 patients with Stanford type A dissecting aneurysms, 19 of whom received medical treatment and 23 of whom had surgical treatment. Among 54 patients with Stanford type B dissecting aneurysms, 24 had medical and 30 had surgical treatments. The treatment results and the long-term outcomes were studied using the Kaplan-Meier method, categorizing the subjects in non-survivor (in-hospital) and survivor groups. The results indicated that those with surgical treatment had a higher survival rate (75%) in the early post-operative course, for both type A and type B aneurysms. However, the long-term outcome of the survivor group was not different between type A and type B aneurysms regardless of type of treatment. Fifty-six percent of cases with type A aneurysms with serious complications survived by medical treatment alone, and no intimal tears were visualized on angiogram. Therefore, it was suggested that, in patients who had no angiographically defined intimal tears in the acute phase, medical treatment may be more effective, even for type A dissecting aneurysms.