Treatment of chronic aortic dissection by transluminal endovascular stent-graft placement: preliminary results.
OBJECTIVE
To investigate efficacy of stent-graft repair for the treatment of patients with chronic aortic dissection.


METHODS
Fifteen patients with chronic aortic dissection were treated with endovascular stent-grafts. Entry tears were located in the descending thoracic aorta in all patients. The mean maximum diameter of the descending thoracic aorta was 47 mm +/- 8. The mean diameter of the true lumen at the same level was 20 mm +/- 5. The mean interval between diagnosis and stent-graft procedure was 32 months +/- 91. Stent-grafts were fabricated from expanded polytetrafluoroethylene and Z-stents.


RESULTS
Stent-grafts were placed successfully in all patients. Two stent-grafts were required in one patient. Entry closure and thrombosis of the false lumen of the descending thoracic aorta were also achieved in all patients. No procedure-related complications were observed except for postimplantation syndrome, including fever and leukocytosis. The diameter of the true lumen was significantly increased (mean, 31 mm +/- 6) at the level of the descending thoracic aorta (P <.01) and the diameter of the aorta was significantly decreased (mean, 44 mm +/- 8) at the same level (P <.01). There were no deaths and no instances of aortic rupture during the subsequent average follow-up period of 24 months. Secondary stent-graft procedures were required to treat the abdominal component of dissection during follow-up in one patient.


CONCLUSIONS
Stent-graft repair of chronic aortic dissection is a safe and effective method and may be an alternative to surgical graft replacement in selected patients. However, further evaluation is mandatory before this method is widely employed.
Kato
N
N
Department of Radiology, Mie University Hospital, Tsu, Japan. kato@mri-gw.mie-u.ac.jp
Hirano
T
T
Shimono
T
T
Ishida
M
M
Takano
K
K
Nishide
Y
Y
Kawaguchi
T
T
Yada
I
I
Takeda
K
K
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000784:Aortic Dissection / Q000628:therapy*; D017545:Aortic Aneurysm, Thoracic / Q000628:therapy*; D001807:Blood Vessel Prosthesis; D002404:Catheterization; D002908:Chronic Disease; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D015607:Stents; D016896:Treatment Outcome