Complicated acute type B dissections--an 8-years experience of endovascular stent-graft repair in a single centre.
OBJECTIVE
To analyze the experience of a single centre using stent-grafts for treatment of complicated acute aortic type B-dissections (EVR-ABD).


METHODS
Retrospective analysis of prospectively collected data from patients undergoing EVR-ABD between January 1997 and December 2004.


METHODS
EVR-ABD was performed in 31 patients (20 males, median age 74 years (IQR: 64-79)). Indications for treatment were aortic rupture (22 patients), intractable pain and hypertension (six patients), acute bowel ischemia (two patients) and transient paraplegia, lower limb and renal ischemia in one patient. Initially home-made devices (five patients) and subsequently commercially available thoracic stent-grafts were used.


RESULTS
Five patients (16%) died within 30 days of EVR-ABD. Postoperative complications occurred in 15 (48%) patients, including one paraplegia converted to paraparesis after cerebrospinal fluid drainage, five strokes, three lower limb ischemia, three myocardial infarction, two pneumonia and one colitis). Re-interventions were required in nine patients (29%). Six more deaths occurred during a median follow-up of 22 (IQR: 16-34) months, two related to the stent-graft and four due to cardiac disease.


CONCLUSIONS
Stent-graft repair of complicated acute type B dissections seems to provide acceptable results and, therefore, it may be considered a valuable alternative to open surgery.
Dias
N V
NV
Department of Vascular Diseases, Malmö-Lund and Endovascular Centre, Malmö University Hospital, Lund University, Malmö, Sweden. nunovdias@hotmail.com
Sonesson
B
B
Koul
B
B
Malina
M
M
Ivancev
K
K
D000208:Acute Disease; D000368:Aged; D000784:Aortic Dissection / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D017130:Angioplasty; D001019:Aortic Rupture / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012189:Retrospective Studies; D015607:Stents; D016896:Treatment Outcome