Comparison of a percutaneous separate stent endograft and a conventional thoracic stent-graft for endovascular repair of type B aortic dissection.
OBJECTIVE
To compare the immediate and midterm outcomes of aortic dissection repair with a separate stent endograft (SSE) versus a conventionally constructed thoracic stent-graft.


METHODS
The records of 35 patients treated for type B aortic dissection from September 1997 to April 2003 were reviewed. Seventeen patients (12 men; mean age 58.8+/-11.6 years) underwent endovascular repair with a separate stent endograft (SSE), a custom-made device with a reduced profile suitable for percutaneous introduction through a 12-F sheath. Eighteen patients (10 men; mean age 56.1+/-12.8 years) underwent treatment with a conventional custom-made stent-graft.


RESULTS
Angiographic success was achieved in 13/17 (76.5%) of the SSE-treated patients and 12/18 (66.7%) for the conventional device group (p=0.521). Clinical success (complete obliteration/thrombosis of the false lumen) was achieved in 12/17 (70.6%) and 11/18 (61.1%), respectively (p=0.555). There were 2 cases of stent-graft movement during deployment and 2 access site complications in the conventional stent-graft group, whereas the SSE patients had no complications. Except for 2 conventional stent-graft patients who were lost to follow-up, all patients are alive at a mean 19.5+/-11.6 months for the SSE group and 34.2+/-21.5 months for the conventional stent-graft patients.


CONCLUSIONS
The separate stent endograft can be deployed percutaneously without the need for blood pressure reduction, achieving accurate deployment without migration. In this small clinical experience, patients treated with the SSE had no access site complications and demonstrated midterm results comparable to the conventional stent-graft cohort, suggesting the possible usefulness of this device for the treatment of thoracic aortic dissection.
Cardiovascular Center, Division of Cardiology, Yonsei University College of Medicine, Seoul, Korea.
Sungha
S
Park
Pil-Ki
PK
Min
Boyoung
B
Joung
Young-Guk
YG
Ko
Donghoon
D
Choi
Yangsoo
Y
Jang
Do Yun
DY
Lee
Byung-Chul
BC
Chang
Won-Heum
WH
Shim
D000328:Adult; D000368:Aged; D000784:Aortic Dissection / Q000601:surgery*; D017130:Angioplasty; D017545:Aortic Aneurysm, Thoracic / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D004867:Equipment Design; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015607:Stents; D016896:Treatment Outcome