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Endovascular Treatment of Type B Thoracic Aortic Dissections
Author(s) -
Lonn Lars,
Delle Martin,
Falkenberg Marten,
Lepore Vincenzo,
Klingenstierna Hans,
Radberg Göran,
Risberg Bo
Publication year - 2003
Publication title -
journal of cardiac surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.428
H-Index - 58
eISSN - 1540-8191
pISSN - 0886-0440
DOI - 10.1046/j.0886-0440.2003.00404.x
Subject(s) - medicine , surgery , paraplegia , stent , perioperative , radiology , endovascular treatment , stroke (engine) , aortic dissection , thrombosis , dissection (medical) , aorta , aneurysm , spinal cord , mechanical engineering , psychiatry , engineering
Purpose: To evaluate the initial experience of endovascular repair of aortic dissections from a single center. Materials and Methods : From June 1999 to March 2002, endovascular stent grafting was performed in 20 high‐risk patients (16 to 80 years). Eighteen patients had a type B dissection (14 acute and 4 chronic). Two patients had chronic type A dissection. Preoperative work‐up included CT and MRI to evaluate the extent of the dissection, the relation to the left subclavian artery, the size of false and true lumen, and branch complications. Results: Stent‐graft deployment was technically successful in all cases. None was converted to open repair. Three patients died within 30 days, i.e., a 15% mortality rate. Four patients (20%) had a perioperative stroke. Paraplegia was observed in one case. No migration of the stent grafts or endoleaks was observed during the mean follow‐up period of 13 months. In all but two patient thrombosis of the false lumen was noted. Conclusions : Endovascular treatment of thoracic dissections is feasible. Early results are encouraging. While endovascular repair with stent‐grafts is progressing rapidly as a viable strategy for aortic dissections in selected patients careful investigations must continue to focus on its safety. Randomized controlled trials are urgently needed. (J Card Surg 2003;18:539‐544)