[Ischemic complications in aortic dissection--percutaneous treatment with balloon fenestration and stent implantation].
OBJECTIVE
To describe principles and results of percutaneous treatment of ischemic complications of aortic dissection.


METHODS
In five cases (four patients) aortic dissection was clinically complicated by renal (n = 4), iliofemoral (n = 2) or mesenterial ischemia (n = 1). After evaluation by means of computed tomography, angiography, and manometry, treatment consisted of balloon fenestration of the intimal flap, stent placement or both.


RESULTS
Eleven of 25 vascular beds were classified as ischemic. Treatment consisted of 11 balloon fenestration procedures in 3 patients, in one case supported by stent placement across the dissection membrane. Stents were placed in five renal arteries, one stent was placed in the true lumen of the aorta. One iliac artery was treated with balloon dilatation. One renal artery dissection became symptomatic after balloon fenestration and was treated successfully by stent placement. In all cases ischemia was resolved by endovascular treatment. All patients had persistent relief of symptoms. Mean follow-up time is 5.8 months.


CONCLUSIONS
Ischemic complications of aortic dissection can be effectively and safely treated with stent placement and balloon fenestration.
Manke
C
C
Institut für Röntgendiagnostik.
Strotzer
M
M
Seitz
J
J
Lenhart
M
M
Aebert
H
H
Kasprzak
P
P
Kaiser
B
B
Feuerbach
S
S
D000328:Adult; D000368:Aged; D000784:Aortic Dissection / Q000150:complications* / Q000000981:diagnostic imaging / Q000628:therapy; D000792:Angiography / Q000295:instrumentation; D000800:Angioplasty, Balloon / Q000295:instrumentation*; D017545:Aortic Aneurysm, Thoracic / Q000150:complications* / Q000000981:diagnostic imaging / Q000628:therapy; D004867:Equipment Design; D005500:Follow-Up Studies; D006801:Humans; D007511:Ischemia / Q000000981:diagnostic imaging / Q000628:therapy*; D007668:Kidney / Q000098:blood supply*; D007866:Leg / Q000098:blood supply*; D008297:Male; D008643:Mesentery / Q000098:blood supply*; D008875:Middle Aged; D015607:Stents; D014057:Tomography, X-Ray Computed / Q000295:instrumentation; D016896:Treatment Outcome