Changes in false lumen after transluminal stent-graft placement in aortic dissections: six years' experience.
BACKGROUND
Transluminal stent-graft placements (TSGPs) are a new, less invasive procedure now recognized as the choice for aortic disease repair. Treatment of aortic dissections with TSGPs has resulted in good early results, but the long-term results and changes in the false lumen have not been elucidated in detail.


RESULTS
TSGPs were performed in 49 patients with primary tears in their descending aortas, and the follow-up period ranged from 4 months to 6 years. The patients were divided into 32 acute-onset and 17 chronic dissections; of the acute-onset cases, there were 15 Stanford type A retrograde dissections. Periodic enhanced spiral CT was conducted after TSGP. The false lumen in the ascending aorta in 14 (93%) of the Stanford type A cases was obliterated completely within 3 months. The CT study was continued for >2 years for 17 acute-onset dissection and 11 chronic dissection patients. The average false lumen diameters of the proximal, middle, and distal descending aorta before treatment were 15.9, 16.2, and 15.6 mm in the acute-onset dissection group and 28.1, 25.2, and 21.0 mm in the chronic dissection group, respectively. The false lumen diameters 2 years after treatment were 3.0, 3.7, and 3.1 mm in the acute-onset dissection group and 10.6, 10.5, and 11.9 mm in the chronic dissection group, respectively. Two years after TSGPs, the false lumen of the thoracic aorta totally disappeared in 76% of the acute-onset dissection group and 36% of the chronic dissection group. No cases showed rupture after TSGP.


CONCLUSIONS
Complete obliteration of the false lumen is more likely in acute-onset cases than in chronic cases.
Kusagawa
Hitoshi
H
Department of Thoracic and Cardiovascular Surgery, Mie University School of Medicine, Tsu, Mie, Japan.
Shimono
Takatsugu
T
Ishida
Masaki
M
Suzuki
Tomoaki
T
Yasuda
Fuyuhiko
F
Yuasa
Uhito
U
Onoda
Koji
K
Yada
Isao
I
Hirano
Tadanori
T
Takeda
Kan
K
Kato
Noriyuki
N
D000368:Aged; D000784:Aortic Dissection / Q000150:complications / Q000628:therapy*; D001014:Aortic Aneurysm / Q000150:complications / Q000628:therapy*; D001807:Blood Vessel Prosthesis / Q000009:adverse effects; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D015607:Stents / Q000009:adverse effects; D013927:Thrombosis / Q000209:etiology; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome