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

Authors
 Ung Kim  ;  Sung-Jin Hong  ;  Jaedeok Kim  ;  Jung-Sun Kim  ;  Young-Guk Ko  ;  Donghoon Choi  ;  Do Yun Lee  ;  Byung-Chul Chang  ;  Won-Heum Shim 
Citation
 JOURNAL OF ENDOVASCULAR THERAPY, Vol.16(1) : 42-47, 2009 
Journal Title
 JOURNAL OF ENDOVASCULAR THERAPY 
ISSN
 1526-6028 
Issue Date
2009
MeSH
Adult ; Aged ; Aneurysm, Dissecting/mortality ; Aneurysm, Dissecting/surgery* ; Aortic Aneurysm, Thoracic/mortality ; Aortic Aneurysm, Thoracic/surgery* ; Blood Vessel Prosthesis* ; Blood Vessel Prosthesis Implantation/adverse effects ; Blood Vessel Prosthesis Implantation/instrumentation* ; Blood Vessel Prosthesis Implantation/mortality ; Chronic Disease ; Female ; Humans ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Polyethylene Terephthalates ; Polytetrafluoroethylene ; Prosthesis Design ; Retrospective Studies ; Stents* ; Time Factors ; Treatment Outcome
Keywords
thoracic aortic dissection ;  type B dissection ;  thoracic endovascular aortic repair ;  stent-graft ;  outcome analysis
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
Full Text
http://jevtonline.org/doi/abs/10.1583/08-2563.1
DOI
10.1583/08-2563.1
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Thoracic and Cardiovascular Surgery (흉부외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Ko, Young Guk(고영국) ORCID logo https://orcid.org/0000-0001-7748-5788
Kim, Woong(김웅)
Kim, Jae Deok(김재덕)
Kim, Jung Sun(김중선) ORCID logo https://orcid.org/0000-0003-2263-3274
Shim, Won Heum(심원흠)
Lee, Do Yun(이도연)
Chang, Byung Chul(장병철)
Choi, Dong Hoon(최동훈) ORCID logo https://orcid.org/0000-0002-2009-9760
Hong, Sung Jin(홍성진) ORCID logo https://orcid.org/0000-0003-4893-039X
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/103741
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