Endovascular stent-graft repair of acute thoracic aortic dissection--early clinical experiences.
BACKGROUND
Standard treatment of acute thoracic aortic dissection type B is the medical therapy used for most patients, according to Stanford. Surgical therapy involves a high mortality rate and is reserved for patients with complicated dissections. We report from four patients with acute thoracic aortic dissection, treated endoluminally by stent-graft implantation.


METHODS
Four patients with complicated acute thoracic aortic dissections type B were treated endoluminally by transfemoral stent-graft implantation. Preoperative evaluation was performed with spiral-computed tomography and calibrated aortography. The Talent stent-graft system (Metronic) was used in all patients.


RESULTS
The primary entry tear could be sealed successfully and complete thrombosis of the false thoracic aortic lumen was obtained in all cases. In one patient, transposition of the left subclavian artery was performed, in two patients the stent-grafts had to be placed across the origin of the left subclavian artery. No severe intra- or postoperative complications occurred.


CONCLUSIONS
Endoluminal treatment of acute thoracic aortic dissection seems to be a less invasive and effective therapy. Long-term results for this method are necessary.
Clinical Department of Vascular Surgery, Karl Franzens University & Medical School of Graz, Austria.
K
K
Tiesenhausen
W
W
Amann
G
G
Koch
K A
KA
Hausegger
P
P
Oberwalder
B
B
Rigler
D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D000784:Aortic Dissection / Q000000981:diagnostic imaging / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000000981:diagnostic imaging / Q000601:surgery*; D001027:Aortography; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D015607:Stents