Stent-Graft treatment of dissecting aneurysm in association with aortic intramural hematoma: when should the procedure be performed?
OBJECTIVE
To report 2 cases of stent-graft implantation for localized dissecting aneurysm during the conservative treatment of aortic intramural hematoma.


METHODS
One patient underwent stent-graft implantation for 2 localized dissecting aneurysms about 23 months after symptom onset. Computed tomography (CT) 1 year after the procedure demonstrated aneurysm shrinkage. In the other patient, a localized dissecting aneurysm was treated about 3 months after symptom onset, even though the intramural hematoma had not resolved. CT scanning 3 months after the procedure demonstrated aneurysm shrinkage, but also revealed poor attachment of the distal stent-graft to the aortic wall due to subsequent resolution of the hematoma.


CONCLUSIONS
Endograft implantation for treatment of localized dissecting aneurysm associated with aortic intramural hematoma should probably not be performed before the hematoma has completely resolved.
Ide
K
K
Department of Radiology, Nara Medical University, Kashihara, Japan.
Kichikawa
K
K
Uchida
H
H
Nagata
T
T
Higashiura
W
W
Sakaguchi
S
S
Kubota
Y
Y
Nishimine
K
K
Ohishi
H
H
D000784:Aortic Dissection / Q000209:etiology / Q000601:surgery*; D001014:Aortic Aneurysm / Q000209:etiology / Q000601:surgery*; D005260:Female; D006406:Hematoma / Q000150:complications / Q000601:surgery*; D006801:Humans; D008875:Middle Aged; D019919:Prosthesis Implantation; D015607:Stents