Treatment of Stanford type B aortic dissection with stent-grafts: preliminary results.
OBJECTIVE
To evaluate the feasibility and safety of endovascular stent-graft placement in treating Stanford type B aortic dissection.


METHODS
Seven patients underwent endovascular stent-graft placement for type B aortic dissection. Five patients had acute and two had chronic dissection. In five patients, the proximal entry tear was within 2 cm of the origin of the left subclavian artery, and in two patients it was beyond this site. In three patients, the noncovered proximal portion of the stent-graft was placed across the origin of the left subclavian artery. The efficacy of the procedure was assessed at follow-up studies 3, 6, 12, and 24 months after intervention.


RESULTS
The procedure was technically and clinically successful in six patients (86%). The left subclavian artery remained patent in all patients. In two patients with involvement of aortic branches, endovascular stent-graft placement restored adequate blood flow to the compromised branches. One patient was readmitted 1 month later because the dissection extended into the ascending aorta. In all but this patient, closure of the entry tear and thrombosis of the false lumen along the stent-graft were achieved. All false lumina shrank considerably. The mean follow-up time was 14 months (range, 1-25 months).


CONCLUSIONS
Type B aortic dissections within and beyond 2 cm of the origin of the left subclavian artery can be treated safely and effectively by means of endovascular stent-graft placement.
Czermak
B V
BV
Department of Radiology I, Leopold-Franzens Medical School and University Hospital Innsbruck, Anichstrasse 35, 6020 Innsbruck, Austria. benedikt.czermak@uibk.ac.at
Waldenberger
P
P
Fraedrich
G
G
Dessl
A H
AH
Roberts
K E
KE
Bale
R J
RJ
Perkmann
R
R
Jaschke
W R
WR
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000784:Aortic Dissection / Q000000981:diagnostic imaging / Q000628:therapy*; D017545:Aortic Aneurysm, Thoracic / Q000000981:diagnostic imaging / Q000628:therapy*; D001807:Blood Vessel Prosthesis; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015641:Radiography, Interventional; D015607:Stents; D014057:Tomography, X-Ray Computed