Misdiagnosed Analysis and Therapeutic Summary of 8 Patients with Painless Stanford B Aortic Dissection

Objective To investigate clinical features and intracavitary repair therapy of painless Stanford B aortic dissection(AD).Methods Clinical data of 8 patients with painless Stanford B AD admitted during January 2003 and May 2012 in our hospital were retrospectively analyzed.Results There was no severe ventrum pain in 8 patients,sore and swoln waist in 2 patients,abdominal distension after meals in 2 patients,dyspnea,cold in lower extremity,intermittent claudication and no subjective symptom in 1 patient.all 8 patients were misdiagnosed at first visit as having gastroenteritis,lubar intervertebral disc protrusion and arteriosclerosis obliterans in lower extremity in 2 patients respectively,heart failure in 1 patient and chronic kidney insufficiency in 1 patient.The possibility of AD was found by normal iconography examination and finally diagnosed by further coherence check.Thoracic endovascular aortic repair(TEVAR) was performed,and the patients recovered well after operation upon discharged.All of the false lumens were filled with thrombosis and the aortic remodelings were considered satisfactory after 3~12 month postoperative follow-up.Conclusion Painless Stanford B aortic dissection may be overlooked or misdiagnosed due to insidious onset and insufficient specific clinical manifestation.TEVAR is a safe and effective therapy for Stanford B AD.