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Elective stent-graft treatment of aortic dissections

Authors
 Kwang-Hun Lee  ;  Jong Yun Won  ;  Byung Chul Chang  ;  Won-Heum Shim  ;  Donghoon Choi  ;  Do Yun Lee 
Citation
 JOURNAL OF ENDOVASCULAR THERAPY, Vol.11(6) : 667-675, 2004 
Journal Title
 JOURNAL OF ENDOVASCULAR THERAPY 
ISSN
 1526-6028 
Issue Date
2004
MeSH
Adult ; Aged ; Aged, 80 and over ; Aneurysm, Dissecting/diagnostic imaging* ; Aneurysm, Dissecting/surgery* ; Aortic Aneurysm, Abdominal/diagnostic imaging ; Aortic Aneurysm, Abdominal/mortality ; Aortic Aneurysm, Abdominal/surgery ; Aortic Aneurysm, Thoracic/diagnostic imaging ; Aortic Aneurysm, Thoracic/mortality ; Aortic Aneurysm, Thoracic/surgery ; Blood Vessel Prosthesis* ; Blood Vessel Prosthesis Implantation/adverse effects ; Blood Vessel Prosthesis Implantation/methods* ; Cohort Studies ; Emergency Treatment/methods ; Female ; Follow-Up Studies ; Humans ; Korea ; Magnetic Resonance Angiography ; Male ; Middle Aged ; Retrospective Studies ; Risk Assessment ; Severity of Illness Index ; Survival Rate ; Tomography, X-Ray Computed ; Treatment Outcome
Keywords
thoracic aorta ; dissection ; stent-graft ; endovascular repair ; complications ; false lumen ; entry tear
Abstract
Purpose: To retrospectively review 8 years' experience with stent-graft treatment of aortic dissections at a single institution. Methods: Forty-six patients (31 men; mean age 59 years, range 38–88) underwent stent-graft treatment for 9 Stanford type A and 37 type B aortic dissections (9 acute phase, 13 subacute, 24 chronic). Custom-designed self-expanding stainless steel Z stents covered with polytetrafluoroethylene were used (n=20) until low-profile modular stent-grafts became available for percutaneous delivery (n=26). Results: Endovascular stent-graft deployment was technically successful in 44 (96%) patients; the 2 failed cases owing to intraprocedural migration and graft torsion were converted to surgery. There were 5 type I endoleaks for a clinical success (entry tear exclusion) of 85% (39/46). Complications included 3 cases of transient renal failure, 2 puncture site pseudoaneurysms, 1 guidewire-induced new intimal tear (converted), and 2 cases of stent-induced saccular aneurysms (1 converted). Follow-up at a mean 34 months (range 12–96) showed complete resolution of the thoracic false lumen in 14 (74%) of 19 acute/subacute patients treated successfully; 3 (16%) showed a reduced thoracic false lumen diameter. In the 23 chronic-phase patients treated successfully, 8 (35%) had complete resolution of the thoracic false lumen, and 11 (48%) showed size reduction. Enlargement of the abdominal aortic false lumen due to persistent flow into re-entry tear(s) occurred in 3 (13%). Conclusions: Stent-graft treatment is a feasible and effective treatment modality in aortic dissection. However, close follow-up is mandatory to monitor new intimal tear, saccular aneurysms, or enlargement of the abdominal aortic false lumen.
Full Text
http://jevtonline.org/doi/full/10.1583/1220MR.1
DOI
10.1583/1220MR.1
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Thoracic and Cardiovascular Surgery (흉부외과학교실) > 1. Journal Papers
Yonsei Authors
Shim, Won Heum(심원흠)
Won, Jong Yun(원종윤) ORCID logo https://orcid.org/0000-0002-8237-5628
Lee, Kwang Hun(이광훈)
Lee, Do Yun(이도연)
Chang, Byung Chul(장병철)
Choi, Dong Hoon(최동훈) ORCID logo https://orcid.org/0000-0002-2009-9760
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/111199
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