{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2023,10,26]],"date-time":"2023-10-26T11:11:51Z","timestamp":1698318711363},"reference-count":25,"publisher":"Akademiai Kiado Zrt.","issue":"16","license":[{"start":{"date-parts":[[2022,4,17]],"date-time":"2022-04-17T00:00:00Z","timestamp":1650153600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["akjournals.com"],"crossmark-restriction":true},"short-container-title":["OH"],"published-print":{"date-parts":[[2022,4,17]]},"abstract":"<jats:p><jats:bold>\u00d6sszefoglal\u00f3.<\/jats:bold>\n                    <jats:italic>Bevezet\u00e9s \u00e9s c\u00e9lkit\u0171z\u00e9s:<\/jats:italic> Az akut Stanford B t\u00edpus\u00fa\n                    aortadissectio (ATBAD) egy potenci\u00e1lisan \u00e9letet vesz\u00e9lyeztet\u0151 k\u00f3rk\u00e9p, melynek\n                    adekv\u00e1t ell\u00e1t\u00e1sa kritikus lehet a beteg t\u00fal\u00e9l\u00e9se szempontj\u00e1b\u00f3l. A jelen\n                    vizsg\u00e1lat c\u00e9lja az ATBAD ell\u00e1t\u00e1s\u00e1val kapcsolatosan v\u00e9gzett konzervat\u00edv, nyitott\n                    vagy endovascularis ter\u00e1pi\u00e1s modalit\u00e1sok r\u00f6vid \u00e9s hossz\u00fa t\u00e1v\u00fa eredm\u00e9nyeinek\n                    \u00f6sszehasonl\u00edt\u00e1sa. <jats:italic>M\u00f3dszer:<\/jats:italic> Retrospekt\u00edv, multicentrikus\n                    kohorszvizsg\u00e1latunk sor\u00e1n a 2011. 01. 01. \u00e9s 2020. 12. 31. k\u00f6z\u00f6tt akut \u00e9s\n                    szubakut TBAD-val kezelt betegeket vizsg\u00e1ltuk. A ter\u00e1pia m\u00f3dja szerint a\n                    konzervat\u00edvan, nyitott m\u0171t\u00e9ttel kezelt \u00e9s a thoracalis endovascularis\n                    aortasztentgraft -implant\u00e1ci\u00f3n (TEVAR) \u00e1tesett betegek eredm\u00e9nyeit hasonl\u00edtottuk\n                    \u00f6ssze. Regisztr\u00e1ltuk a posztoperat\u00edv 30 napban t\u00f6rt\u00e9nt hal\u00e1loz\u00e1st, major\n                    sz\u00f6v\u0151dm\u00e9nyeket, valamint az ut\u00e1nk\u00f6vet\u00e9s sor\u00e1n val\u00f3 reoper\u00e1ci\u00f3 sz\u00fcks\u00e9gess\u00e9g\u00e9t \u00e9s\n                    a t\u00fal\u00e9l\u00e9st. <jats:italic>Eredm\u00e9nyek:<\/jats:italic> A vizsg\u00e1latba 188 beteget vontunk be\n                    (69,7% f\u00e9rfi, \u00e1tlag\u00e9letkor: 57 \u00b1 12,2 \u00e9v). A betegek 88,8%-a szenvedett\n                    magasv\u00e9rnyom\u00e1s-betegs\u00e9gben. A posztoperat\u00edv 30 napban a nyitott m\u0171t\u00e9ten \u00e1tesett\n                    betegek k\u00f6z\u00f6tt magasabb ar\u00e1nyban fordult el\u0151 hal\u00e1loz\u00e1s, mint a TEVAR-on \u00e1tesett\n                    betegek k\u00f6z\u00f6tt (26% \u00e9s 16,7%, p = 0,12). A nyitott m\u0171t\u00e9ten \u00e9s a TEVAR-on \u00e1tesett\n                    betegek k\u00f6z\u00f6tt hasonl\u00f3an magas ar\u00e1nyban fordult el\u0151 posztoperat\u00edv l\u00e9legeztet\u00e9st\n                    ig\u00e9nyl\u0151 t\u00fcd\u0151sz\u00f6v\u0151dm\u00e9ny (22,6% \u00e9s 19,4%), valamint m\u0171t\u00e9tet ig\u00e9nyl\u0151 vascularis\n                    sz\u00f6v\u0151dm\u00e9ny (25,9% \u00e9s 16,7%). A konzervat\u00edvan kezelt csoportban 3 esetben volt\n                    sz\u00fcks\u00e9ges a dissecti\u00f3val kapcsolatos m\u0171t\u00e9t v\u00e9gz\u00e9se 30 napon bel\u00fcl (renalis\n                    sztentimplant\u00e1ci\u00f3: n = 2, TEVAR: n = 1). A medi\u00e1n ut\u00e1nk\u00f6vet\u00e9si id\u0151 41 (IQR,\n                    73,5) h\u00f3nap volt. Ut\u00e1nk\u00f6vet\u00e9s\u00fcnk alatt a reoper\u00e1ci\u00f3k tekintet\u00e9ben nem volt\n                    szignifik\u00e1ns k\u00fcl\u00f6nbs\u00e9g a h\u00e1rom csoport k\u00f6z\u00f6tt (p = 0,428). A 6 \u00e9ves t\u00fal\u00e9l\u00e9s a\n                    nyitott m\u0171t\u00e9ten \u00e1tesett betegek k\u00f6z\u00f6tt szignifik\u00e1nsan alacsonyabb volt, mint a\n                    m\u00e1sik k\u00e9t vizsg\u00e1lt betegcsoportban (54,8% <jats:italic>vs.<\/jats:italic> 79,3% \u00e9s 75%, p =\n                    0,017). <jats:italic>K\u00f6vetkeztet\u00e9s:<\/jats:italic> Amennyiben ATBAD eset\u00e9n m\u0171t\u00e9t indik\u00e1lt,\n                    TEVAR v\u00e9gz\u00e9se el\u0151ny\u00f6sebb a nyitott m\u0171t\u00e9thez k\u00e9pest mind a r\u00f6vid, mind a hossz\u00fa\n                    t\u00e1v\u00fa eredm\u00e9nyek tekintet\u00e9ben. A nem komplik\u00e1lt esetekben folytatott konzervat\u00edv\n                    ter\u00e1pia hossz\u00fa t\u00e1v\u00fa eredm\u00e9nyei nem mutatnak szignifik\u00e1ns k\u00fcl\u00f6nbs\u00e9get a TEVAR\n                    eredm\u00e9nyeihez k\u00e9pest. Orv Hetil. 2022; 163(16): 637\u2013644.<\/jats:p>\n                <jats:p><jats:bold>Summary.<\/jats:bold>\n                    <jats:italic>Introduction and objective:<\/jats:italic> Acute Stanford type B aortic\n                    dissection (ATBAD) is a potentially life-threatening condition, which may\n                    require immediate intervention. This study aims to compare the short- and\n                    long-term results of medical, open surgical and endovascular management of\n                    ATBAD. <jats:italic>Method:<\/jats:italic> This is a retrospective, multi-centre cohort\n                    study, where patients admitted with acute and subacute TBAD between Jan. 2011\n                    and Dec. 2020 were included. Results were compared between patients treated with\n                    medical, open surgical and thoracic endovascular aortic repair (TEVAR). 30-day\n                    mortality and major complications were registered. Survival and freedom from\n                    reintervention were noted. <jats:italic>Results:<\/jats:italic> A total number of 188\n                    patients were included (69.7% man, mean age: 57 \u00b1 12.2 years). Hypertension was\n                    present in 88.8% of the patients. The 30-day mortality was more higher among\n                    patients who underwent open surgery, than among patients after TEVAR (26% and\n                    16.7%, p = 0.12). Postoperative lung complication (22.6% and 19.4%) and vascular\n                    complication (25.9% and 16.7%) were common in both open and TEVAR groups. In the\n                    conservatively treated group, three patients required intervention in the first\n                    30 days (renal stent implantation: n = 2, TEVAR: n = 1). Median follow-up was 41\n                    (IQR, 73.5) months. There was no significant difference in reoperations during\n                    follow-up between the three groups (p = 0.428). 6-year survival was\n                    significantly lower among patients with open surgery compared to the other two\n                    patient populations (54.8% <jats:italic>vs.<\/jats:italic> 79.3% and 75%, p = 0.017).\n                        <jats:italic>Conclusion:<\/jats:italic> In the invasive treatment of ATBAD, TEVAR is\n                    associated with superior short- and long-term complication rate, and survival.\n                    There is no significant difference between the long-term results of medical\n                    therapy and TEVAR. Orv Hetil. 2022; 163(16): 637\u2013644.<\/jats:p>","DOI":"10.1556\/650.2022.32430","type":"journal-article","created":{"date-parts":[[2022,11,18]],"date-time":"2022-11-18T22:24:42Z","timestamp":1668810282000},"page":"637-644","update-policy":"http:\/\/dx.doi.org\/10.1556\/policypage.crossmark.crossref.1","source":"Crossref","is-referenced-by-count":0,"title":["Akut Stanford B t\u00edpus\u00fa aortadissectio konzervat\u00edv \u00e9s invaz\u00edv ter\u00e1pi\u00e1j\u00e1nak hossz\u00fa t\u00e1v\u00fa eredm\u00e9nyei Magyarorsz\u00e1gon"],"prefix":"10.1556","volume":"163","author":[{"given":"P\u00e9ter","family":"Legeza","sequence":"first","affiliation":[{"name":"Semmelweis Egyetem, \u00c1ltal\u00e1nos Orvostudom\u00e1nyi Kar, V\u00e1rosmajori Sz\u00edv- \u00e9s \u00c9rgy\u00f3gy\u00e1szati Klinika, \u00c9rseb\u00e9szeti \u00e9s Endovaszkul\u00e1ris Tansz\u00e9k Budapest, V\u00e1rosmajor u. 68., 1122 Magyarorsz\u00e1g"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Enik\u0151","family":"Pomozi","sequence":"additional","affiliation":[{"name":"Semmelweis Egyetem, \u00c1ltal\u00e1nos Orvostudom\u00e1nyi Kar, V\u00e1rosmajori Sz\u00edv- \u00e9s \u00c9rgy\u00f3gy\u00e1szati Klinika, \u00c9rseb\u00e9szeti \u00e9s Endovaszkul\u00e1ris Tansz\u00e9k Budapest, V\u00e1rosmajor u. 68., 1122 Magyarorsz\u00e1g"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tam\u00e1s","family":"T\u00f3th","sequence":"additional","affiliation":[{"name":"Magyar Honv\u00e9ds\u00e9g, Eg\u00e9szs\u00e9g\u00fcgyi K\u00f6zpont, Honv\u00e9dk\u00f3rh\u00e1z, \u00c9rseb\u00e9szeti R\u00e9szleg, Sz\u00edv-, \u00c9r- \u00e9s Mellkasseb\u00e9szeti Oszt\u00e1ly Budapest Magyarorsz\u00e1g"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"L\u00e1szl\u00f3","family":"Benk\u0151","sequence":"additional","affiliation":[{"name":"P\u00e9csi Tudom\u00e1nyegyetem, \u00c1ltal\u00e1nos Orvostudom\u00e1nyi Kar, \u00c9rseb\u00e9szeti Klinika P\u00e9cs Magyarorsz\u00e1g"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gy\u00f6rgy","family":"Juh\u00e1sz","sequence":"additional","affiliation":[{"name":"Borsod-Aba\u00faj-Zempl\u00e9n Megyei K\u00f6zponti K\u00f3rh\u00e1z \u00e9s Egyetemi Oktat\u00f3k\u00f3rh\u00e1z, \u00c9r- \u00e9s Endovascularis Seb\u00e9szeti Oszt\u00e1ly Miskolc Magyarorsz\u00e1g"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zsolt","family":"K\u00f6vesi","sequence":"additional","affiliation":[{"name":"Petz Alad\u00e1r Egyetemi Oktat\u00f3 K\u00f3rh\u00e1z, \u00c9rseb\u00e9szeti Oszt\u00e1ly Gy\u0151r Magyarorsz\u00e1g"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"\u00c9va","family":"Veres","sequence":"additional","affiliation":[{"name":"Gottsegen Gy\u00f6rgy Orsz\u00e1gos Kardiovaszkul\u00e1ris Int\u00e9zet, \u00c9rseb\u00e9szeti Oszt\u00e1ly Budapest Magyarorsz\u00e1g"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"L\u00f3r\u00e1nt","family":"Ill\u00e9sy","sequence":"additional","affiliation":[{"name":"Debreceni Egyetem, \u00c1ltal\u00e1nos Orvostudom\u00e1nyi Kar, Seb\u00e9szeti Int\u00e9zet Budapest Magyarorsz\u00e1g"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zolt\u00e1n","family":"Szeberin","sequence":"additional","affiliation":[{"name":"Semmelweis Egyetem, \u00c1ltal\u00e1nos Orvostudom\u00e1nyi Kar, V\u00e1rosmajori Sz\u00edv- \u00e9s \u00c9rgy\u00f3gy\u00e1szati Klinika, \u00c9rseb\u00e9szeti \u00e9s Endovaszkul\u00e1ris Tansz\u00e9k Budapest, V\u00e1rosmajor u. 68., 1122 Magyarorsz\u00e1g"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"425","reference":[{"key":"ref0","unstructured":"1 Trimarchi S, Tolenaar JL, Tsai TT, et al. 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