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Emergency Stent‐Graft Placement in Thoracic Aortic Dissection and Evolving Rupture
Author(s) -
Nienaber Christoph A.,
Ince Hüseyin,
Weber Frank,
Rehders Tim,
Petzsch Michael,
Meinertz Thomas,
Koschyk Dietmar H.
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.1540-8191.2003.02082.x
Subject(s) - medicine , surgery , stent , aortic dissection , dissection (medical) , aorta , aortic rupture , radiology , aortic aneurysm
Background: Even with rapid diagnosis and effective medical treatment mortality in type B aortic dissection with evidence of extraaortic leakage of blood remains high. Considering a mortality rate of 29% to 50% associated with emergency surgical repair, the concept of endovascular stent‐graft placement may become a life‐saving option in impending or evolving rupture by endovascular sealing of the entry tear and subsequent abortion of leakage. Methods: The concept was tested by comparing short‐term and 1‐year outcomes of 11 patients after emergency endovascular stent‐graft placement with historic‐matched control patients subjected to conventional therapy. All patients had acute type B dissection complicated by loss of blood into periaortic spaces. Results: Emergency stent‐graft placement was successful without periprocedural morbidity, aborted leakage, and ensured reconstruction of the dissected aorta; at a mean follow‐up of 15 ± 6 months no death had occurred in the stent‐graft group whereas four patients had died with conventional treatment (p < 0.05) . Conclusion: With appropriate logistics and expertise, type B aortic dissection with leakage and evolving rupture may benefit from nonsurgical reconstruction of the dissected segment by endovascular stent grafts.