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 article

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 1

Fingerprint

Stents
Dissection
Transplants
Tunica Intima
Thorax
Tears
Therapeutics
Aneurysm
Endoleak
False Aneurysm
Stainless Steel
Polytetrafluoroethylene
Punctures
Renal Insufficiency

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

Lee, K. H., Jong, Y. W., Do, Y. L., Choi, D., Shim, W. H., & Byung, C. C. (2004). Elective stent-graft treatment of aortic dissections. Journal of Endovascular Therapy, 11(6), 667-675. https://doi.org/10.1583/1220MR.1
Lee, Kwang Hun ; Jong, Yun Won ; Do, Yun Lee ; Choi, Donghoon ; Shim, Won Heum ; Byung, Chul Chang. / Elective stent-graft treatment of aortic dissections. In: Journal of Endovascular Therapy. 2004 ; Vol. 11, No. 6. pp. 667-675.
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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.",
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Lee, KH, Jong, YW, Do, YL, Choi, D, Shim, WH & Byung, CC 2004, 'Elective stent-graft treatment of aortic dissections', Journal of Endovascular Therapy, vol. 11, no. 6, pp. 667-675. https://doi.org/10.1583/1220MR.1

Elective stent-graft treatment of aortic dissections. / Lee, Kwang Hun; Jong, Yun Won; Do, Yun Lee; Choi, Donghoon; Shim, Won Heum; Byung, Chul Chang.

In: Journal of Endovascular Therapy, Vol. 11, No. 6, 01.12.2004, p. 667-675.

Research output: Contribution to journalReview article

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T1 - Elective stent-graft treatment of aortic dissections

AU - Lee, Kwang Hun

AU - Jong, Yun Won

AU - Do, Yun Lee

AU - Choi, Donghoon

AU - Shim, Won Heum

AU - Byung, Chul Chang

PY - 2004/12/1

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N2 - 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.

AB - 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.

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