Percutaneous placement of a low-profile stent-graft device for aortic dissections.
OBJECTIVE
The use of stent-grafts has proved to be safe and effective treatment for complicated aortic dissections but usually requires surgical cutdown to accommodate large-profile devices. Preliminary results of the use of a low-profile design that allows percutaneous access are presented.


METHODS
Fifteen patients with aortic dissection were treated with use of a low-profile stent-graft. Dissection types included Stanford type A (n = 6) and type B (n = 9). The procedures were performed with use of Perclose devices to achieve hemostasis. The stent-graft device was composed of Gianturco stents connected with longitudinal wire struts covered with radially expanded polytetrafluoroethylene. The delivery sheath sizes were 14-20 F.


RESULTS
In 87% of patients (13 of 15), the entry tear was excluded completely. Successful femoral closures were achieved in 93% of patients (14 of 15) with use of the suture-mediated devices. In 7% of patients (one of 15), surgical closure of the femoral arteries was required. The rate of pseudoaneurysm occurrence was 7% (one of 15). Hospitalization ranged from 1 to 30 days with a mean duration of 6.5 days. The 30-day mortality rate was 27% (four of 15). In the remaining 11 patients, entry tear sites were excluded and, on follow-up CT examinations, there was thrombosis and retraction of the false lumen and enlargement of the true lumen.


CONCLUSIONS
Preliminary results of the use of a low-profile stent-graft device to treat aortic dissections show that, in most patients, it can be used with a suture-mediated device without surgical exposure of the common femoral artery.
Quinn
Stephen F
SF
Radiology Associates, PC, P.O. Box 482, Eugene, Oregon 97440, USA. squinn@spacehealth.org
Duke
David J
DJ
Baldwin
Stanley S
SS
Bascom
Thomas H
TH
Ruff
Stanley J
SJ
Swangard
Robert J
RJ
DeHaas
David R
DR
Padgett
Richard C
RC
Bergin
Patrick J
PJ
Lau
Samuel
S
D000328:Adult; D000368:Aged; D000784:Aortic Dissection / Q000150:complications / Q000000981:diagnostic imaging / Q000628:therapy*; D001014:Aortic Aneurysm / Q000150:complications / Q000000981:diagnostic imaging / Q000628:therapy*; D001027:Aortography; D001807:Blood Vessel Prosthesis; D002406:Catheterization, Peripheral; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015641:Radiography, Interventional; D015607:Stents; D014057:Tomography, X-Ray Computed