Self-expandable aortic stent-grafts for treatment of descending aortic dissections.
BACKGROUND
Acute aortic dissection is a life-threatening medical condition that is associated with high morbidity and mortality.


METHODS
Of 198 patients treated with a self-expanding polyester-covered stent-graft for various pathologic aortic conditions in our institution, we selected 70 consecutive patients with type B aortic dissection who were undergoing treatment. The stent-graft was introduced through the femoral artery in the angiography suite, under general anesthesia with systemic heparinization and induced hypotension.


RESULTS
The procedure was performed in 70 patients; of these, 58 had descending aortic dissection and 12 had atypical dissections. The procedure was successful in 65 patients (92.9%), as documented by exclusion of the false lumen of the thoracic aorta. Eleven patients (18.9%) had persistent blood flow in the false lumen of the abdominal aorta due to distal reentries. Five patients (7.1%) underwent conversion to surgery. Insertion of additional stent-grafts was required in 34 patients (48.6%). At 29 months of follow-up, 91.4% of the patients were alive.


CONCLUSIONS
Stent-grafts are an important means of treating aortic dissections, which may replace conventional medical treatment of this condition for the majority of patients.
Palma
J Honório
JH
Cardiovascular Surgery, Medical School, São Paulo Federal University, São Paulo, Brazil. jhpalma.dcir@epm.br
de Souza
Jose Augusto Marcondes
JA
Rodrigues Alves
Claudia Maria
CM
Carvalho
Antonio Carlos
AC
Buffolo
Enio
E
D000208:Acute Disease; D000784:Aortic Dissection / Q000628:therapy*; D001013:Aorta, Thoracic / Q000000981:diagnostic imaging; D017545:Aortic Aneurysm, Thoracic / Q000628:therapy*; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods; D002406:Catheterization, Peripheral; D005260:Female; D005263:Femoral Artery; D006801:Humans; D008297:Male; D008875:Middle Aged; D015641:Radiography, Interventional; D015607:Stents