Endovascular stent-graft repair of aortic dissection.
Between October 2000 and January 2002, 9 consecutive male patients with subacute or chronic aortic dissection underwent stent-graft placement. The indication for surgery was continuous pain or aneurysm development. One patient had a type A dissecting aortic aneurysm with a primary tear in the ascending thoracic aorta; the other 8 had type B dissection. Placement of an endovascular stent-graft was technically successful in 8 patients, and one underwent an open procedure for abdominal aortic fenestration. The entry site was sealed and the false lumen disappeared in 8 cases, and thrombosis of the false lumen was obtained. Rupture of an iliac artery dissecting aneurysm occurred in one patient 2 days after stent-graft placement; abdominal aortic fenestration with prosthetic replacement of the distal abdominal aorta was performed. One patient died of myocardial infarction 3 days after the stent-graft procedure. During a mean follow-up period of 7 months (1-16 months), one patient died of acute myocardial infarction at 11 months. It was concluded on the basis of these short-term results that endovascular repair of aortic dissection is a promising treatment, and abdominal aortic fenestration is a useful adjuvant procedure.
Li
Xiao-Xi
XX
Department of Surgery, First Affiliated Hospital, Sun Yat-sen University, Guangzhou, People's Republic of China. lix2@21cn.com
Wang
Sheng-Ming
SM
Chen
Wei
W
Zhuang
Wen-Quan
WQ
Wu
Zhuan-Hong
ZH
Chang
Guang-Qi
GQ
Li
Song-Qi
SQ
Yang
Jian-Yong
JY
Lin
Yong-Jie
YJ
D000328:Adult; D000368:Aged; D000784:Aortic Dissection / Q000601:surgery*; D017544:Aortic Aneurysm, Abdominal / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000601:surgery*; D001019:Aortic Rupture / Q000209:etiology / Q000401:mortality / Q000601:surgery; D019917:Blood Vessel Prosthesis Implantation; D002681:China; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology / Q000401:mortality / Q000601:surgery; D012086:Reoperation; D015607:Stents; D016019:Survival Analysis; D016896:Treatment Outcome