What are the treatment options for an aortic dissection? Three treatment options
exist for an aortic dissection: 1) medical management, 2) interventional
catheterization, and 3) cardiovascular surgery. Depending upon the location and
severity of the dissection, your physician will decide which option is best for
you. A small percent of cases (5 - 10%) are Type B dissections (dissections of
the descending aorta). This condition can be treated with surgical repair, but
it carries significant risk. Typically, your doctor will monitor the condition
periodically and prescribe medications to control the dissection. The techniques
used to treat dissections are as follows:
• Medical Therapy: Blood pressure and cholesterol lowering drugs, and treatment
to reverse arteriosclerosis
• Endovascular Intervention: This minimally invasive procedure requires small
incisions in the groin. Small wire-like, catheter devices called endoluminal
stent grafts are threaded to the location of the dissection. These devices have
a woven synthetic graft tip, which is deployed at the site of dissection and
left in place. This provides a channel for blood to flow freely, repairing
arterial leakage, and preventing pressure from rupturing the aorta. This
procedure is much less invasive than the traditional open surgery, usually with
a hospital stay of about 2-3 days and a recuperation period of a couple of
weeks. Please note: This procedure can only be performed on specific patients
based on clinical criteria, and no long-term data exists regarding its
effectiveness compared to open surgery.
• Open Surgical Repair: The traditional treatment technique involves opening the
chest and surgical removing the dissected aorta. A synthetic graft is sewn in
its place for blood to flow freely to the rest of the arterial system. This
procedure often requires a hospital stay of a week or more, and recuperation can
take 6-8 weeks.
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