合併症のない亜急性ないし慢性Stanford B 型大動脈解離に対する胸部ステントグラフト内挿術の治療戦略―発症から治療までの期間，治療時の瘤径から

We classified 59 patients who underwent thoracic endovascular aortic repair for uncomplicated type B aortic dissection from April 2008 to April 2016 into 3 groups based on time from onset and maximum aortic diameter：SA （2weeks to 1 year since onset；n＝29）, C （＞1 year since onset；n＝17）, and D（maximum aneurysm size≧60 mm；n＝13）. We used the Kaplan-Meier method to analyze survival, major adverse cardiovascular event and the need for additional treatment. There was no significant difference in outcomes between the SA and C groups （p＝0.998） or C and D groups （p＝0.279）, but the results in group D tended to be consistently inferior. The freedom from aneurysm rupture rate was inferior in this group, with a significant difference between groups C and D （p＝0.044）. The time from onset to the procedure and maximum aortic diameter were not significantly associated with the longterm outcomes；however, more aortic ruptures occurred in the group with maximum aortic diameter≧60 mm. Simultaneous treatment for re-entry closure or conventional surgical procedures should be considered for such cases.