title: [Malperfusion in aortic dissection: diagnostic problems and therapeutic procedures].
abstract: Malperfusion of the thoracoabdominal aorta and its side branches is a common complication of aortic dissection, often proving fatal. Vital organ malperfusion accompanying acute aortic dissection is a major cause of mortality and morbidity and requires timely reperfusion of the ischemic organs as well as adequate management of the aortic dissection. Ischemic damage to vital organs supplied by the thoracoabdominal aorta greatly increases the overall risk of aortic dissection. As initial symptoms may be subtle, malperfusion tends to be recognized late, and therefore accounts for a considerable percentage of fatalities.Effective reperfusion is not readily achieved by central aortic surgery alone in a certain number of patients. Various strategies have been used, including entry closure by central aortic surgery or stent grafting, surgical or catheter fenestration, bypass grafting and percutaneous stenting.Endovascular bare-metal stent placement is an attractive and promising treatment option since it is readily available, is less invasive and presents fewer risks to the patient.
authors.affiliation: Klinik für Kardiologie, Westdeutsches Herzzentrum Essen, Universitätsklinikum Essen, Universität Duisburg-Essen, Hufelandstr. 55, 45122, Essen, Deutschland. alexander.janosi@uk-essen.de
authors.forename: R A
authors.initials: RA
authors.lastname: Jánosi
authors.forename: D
authors.initials: D
authors.lastname: Böse
authors.forename: T
authors.initials: T
authors.lastname: Konorza
authors.forename: H
authors.initials: H
authors.lastname: Eggebrecht
authors.forename: K
authors.initials: K
authors.lastname: Tsagakis
authors.forename: H
authors.initials: H
authors.lastname: Jakob
authors.forename: R
authors.initials: R
authors.lastname: Erbel
mesh_terms: D000006:Abdomen, Acute / Q000209:etiology / Q000401:mortality / Q000601:surgery; D058186:Acute Kidney Injury / Q000175:diagnosis / Q000401:mortality / Q000601:surgery; D000368:Aged; D000784:Aortic Dissection / Q000175:diagnosis* / Q000401:mortality / Q000601:surgery; D017130:Angioplasty; D017545:Aortic Aneurysm, Thoracic / Q000175:diagnosis* / Q000401:mortality / Q000601:surgery; D001157:Arterial Occlusive Diseases / Q000175:diagnosis / Q000401:mortality / Q000601:surgery; D019917:Blood Vessel Prosthesis Implantation; D002423:Cause of Death; D002445:Celiac Artery; D017548:Echocardiography, Transesophageal; D005121:Extremities / Q000098:blood supply; D005260:Female; D006801:Humans; D007511:Ischemia / Q000175:diagnosis* / Q000601:surgery; D007668:Kidney / Q000098:blood supply; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000175:diagnosis / Q000401:mortality / Q000601:surgery; D012307:Risk Factors; D015607:Stents; D014057:Tomography, X-Ray Computed; D014781:Viscera / Q000098:blood supply