Intermediate to long-term outcomes of endoluminal stent-graft repair in patients with chronic type B aortic dissection

Ung Kim, Sung Jin Hong, Jaedeok Kim, Jung Sun Kim, Young Guk Ko, Donghoon Choi, Do Yun Lee, Byung Chul Chang, Won Heum Shim

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Abstract

Purpose: To assess mid- to long-term clinical results of stent-graft repair in patients with type B aortic dissection. Methods: Retrospective analysis was done on 72 patients (47 men; mean age 55±12 years) who were diagnosed with chronic type B aortic dissection and underwent stent-graft repair from June 1994 to December 2007. Two types of stent-grafts were employed. Prior to 2000, a custom-designed stent-graft composed of self-expanding Z-type stainless steel stents covered with woven polytetrafluoroethylene material was used. Thereafter, a separate-type (modular) manufactured stent-graft was used, consisting of proximal and distal nitinol stents with an unsupported Dacron tube graft in between; the unsupported graft was stented after deployment. Results: Procedural success (completion of the stent-graft deployment at the target area without device failure) was obtained in 97% (70/72). The 2 failures were due to stent migration and tortuous anatomy, respectively. There were persistent type I endoleaks in 6 cases for a clinical success (entry tear exclusion) of 88% (64/72). There was no immediate postprocedural mortality or paraplegia. There was unintended partial left subclavian artery occlusion in 1 case, as well as postprocedural transient renal failure in 1 patient and 2 access-site pseudoaneurysms. Median follow-up was 43 months (range 5-97, mean 64.4±38.8) in 61 patients (3 patients lost to follow-up). Five patients died, 1 of probable aortic rupture in the setting of residual type I endoleak. Overall clinical success (no death, conversion, or endoleak) was achieved in 84% (47/56); of these, 35 (74%) showed complete resolution of the thoracic false lumen, while the other 12 (26%) had a decrease in false lumen diameter. Conclusions: Intermediate to long-term results of stent-graft implantation in patients with chronic type B aortic dissection seem acceptable and may justify the use of this minimally invasive approach as first line therapy in these patients.

Original languageEnglish
Pages (from-to)42-47
Number of pages6
JournalJournal of Endovascular Therapy
Volume16
Issue number1
DOIs
Publication statusPublished - 2009 Feb 1

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All Science Journal Classification (ASJC) codes

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

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