Elective stent-graft treatment of aortic dissections

Kwang Hun Lee, Yun Won Jong, Yun Lee Do, Donghoon Choi, Won Heum Shim, Chul Chang Byung

Research output: Contribution to journalReview articlepeer-review

28 Citations (Scopus)

Abstract

Purpose: To retrospectively review 8 years' experience with stent-graft treatment of aortic dissections at a single institution. Methods: Forty-six patients (31 men; mean age 59 years, range 38-88) underwent stent-graft treatment for 9 Stanford type A and 37 type B aortic dissections (9 acute phase, 13 subacute, 24 chronic). Custom-designed self-expanding stainless steel Z stents covered with polytetrafluoroethylene were used (n=20) until low-profile modular stent-grafts became available for percutaneous delivery (n=26). Results: Endovascular stent-graft deployment was technically successful in 44 (96%) patients; the 2 failed cases owing to intraprocedural migration and graft torsion were converted to surgery. There were 5 type I endoleaks for a clinical success (entry tear exclusion) of 85% (39/46). Complications included 3 cases of transient renal failure, 2 puncture site pseudoaneurysms, 1 guidewire-induced new intimal tear (converted), and 2 cases of stent-induced saccular aneurysms (1 converted). Follow-up at a mean 34 months (range 12-96) showed complete resolution of the thoracic false lumen in 14 (74%) of 19 acute/subacute patients treated successfully; 3 (16%) showed a reduced thoracic false lumen diameter. In the 23 chronic-phase patients treated successfully, 8 (35%) had complete resolution of the thoracic false lumen, and 11 (48%) showed size reduction. Enlargement of the abdominal aortic false lumen due to persistent flow into re-entry tear(s) occurred in 3 (13%). Conclusions: Stent-graft treatment is a feasible and effective treatment modality in aortic dissection. However, close follow-up is mandatory to monitor new intimal tear, saccular aneurysms, or enlargement of the abdominal aortic false lumen.

Original languageEnglish
Pages (from-to)667-675
Number of pages9
JournalJournal of Endovascular Therapy
Volume11
Issue number6
DOIs
Publication statusPublished - 2004 Dec

All Science Journal Classification (ASJC) codes

  • Surgery
  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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