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

Research output: Contribution to journalArticle

32 Citations (Scopus)

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

Fingerprint

Stents
Dissection
Transplants
Endoleak
Equipment Failure
Aortic Rupture
Polyethylene Terephthalates
Subclavian Artery
Paraplegia
Lost to Follow-Up
False Aneurysm
Stainless Steel
Polytetrafluoroethylene
Tears
Renal Insufficiency
Anatomy
Thorax
Mortality

All Science Journal Classification (ASJC) codes

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

Cite this

Kim, Ung ; Hong, Sung Jin ; Kim, Jaedeok ; Kim, Jung Sun ; Ko, Young Guk ; Choi, Donghoon ; Lee, Do Yun ; Chang, Byung Chul ; Shim, Won Heum. / Intermediate to long-term outcomes of endoluminal stent-graft repair in patients with chronic type B aortic dissection. In: Journal of Endovascular Therapy. 2009 ; Vol. 16, No. 1. pp. 42-47.
@article{09e6d47734a64ee7b993d989e801a910,
title = "Intermediate to long-term outcomes of endoluminal stent-graft repair in patients with chronic type B aortic dissection",
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.",
author = "Ung Kim and Hong, {Sung Jin} and Jaedeok Kim and Kim, {Jung Sun} and Ko, {Young Guk} and Donghoon Choi and Lee, {Do Yun} and Chang, {Byung Chul} and Shim, {Won Heum}",
year = "2009",
month = "2",
day = "1",
doi = "10.1583/08-2563.1",
language = "English",
volume = "16",
pages = "42--47",
journal = "Journal of Endovascular Therapy",
issn = "1526-6028",
publisher = "International Society of Endovascular Specialists",
number = "1",

}

Intermediate to long-term outcomes of endoluminal stent-graft repair in patients with chronic type B aortic dissection. / Kim, Ung; Hong, Sung Jin; Kim, Jaedeok; Kim, Jung Sun; Ko, Young Guk; Choi, Donghoon; Lee, Do Yun; Chang, Byung Chul; Shim, Won Heum.

In: Journal of Endovascular Therapy, Vol. 16, No. 1, 01.02.2009, p. 42-47.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Intermediate to long-term outcomes of endoluminal stent-graft repair in patients with chronic type B aortic dissection

AU - Kim, Ung

AU - Hong, Sung Jin

AU - Kim, Jaedeok

AU - Kim, Jung Sun

AU - Ko, Young Guk

AU - Choi, Donghoon

AU - Lee, Do Yun

AU - Chang, Byung Chul

AU - Shim, Won Heum

PY - 2009/2/1

Y1 - 2009/2/1

N2 - 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.

AB - 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.

UR - http://www.scopus.com/inward/record.url?scp=61449245676&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=61449245676&partnerID=8YFLogxK

U2 - 10.1583/08-2563.1

DO - 10.1583/08-2563.1

M3 - Article

VL - 16

SP - 42

EP - 47

JO - Journal of Endovascular Therapy

JF - Journal of Endovascular Therapy

SN - 1526-6028

IS - 1

ER -