title: Midterm results of aortic diameter outcomes after thoracic stent-graft implantation for aortic dissection: a multicenter study.
abstract: OBJECTIVE
  To evaluate aortic diameter outcomes after stent-graft implantation for aortic dissection in the descending thoracic aorta.
  
  
  METHODS
  Fifty patients with type A dissection after ascending aortic surgery (n = 10), type B dissection (n = 34), or intramural hematoma (n = 6) underwent stent-graft repair in 3 centers. Thrombosis and aortic diameter were analyzed by computed tomographic angiography at different levels of the aorta before stent-graft implantation, at discharge, and at follow-up. Measurements were standardized.
  
  
  RESULTS
  In all, 67 stent-grafts were implanted for acute (n = 18) and chronic (n = 32) dissection. Stent-graft placement was successfully performed with high technical success (100%) despite 4 major complications (iliac thrombosis in 2 cases, aortic rupture, and a type A dissection) in 3 (6%) patients. Complete thrombosis of the thoracic false lumen was observed in 42% and 63% of cases at discharge and at follow-up (mean 15 months), respectively. At follow-up, the diameters of the entire aorta (mean 5 mm, p < 0.05) and the false lumen (mean 11 mm, p < 0.0001) decreased. Diameters of the abdominal aorta remained stable in association with persistent false lumen perfusion at this level. Aortic diameter results were better in the subgroup of patients with intramural hematoma compared to patients with Marfan syndrome. Three early deaths unrelated to the stent-graft procedure occurred; 2 patients with partial thrombosis of the false lumen died in follow-up secondary to aortic diameter growth.
  
  
  CONCLUSIONS
  Complete thrombosis of the false lumen by stent-graft coverage of the entry tear results in decreased diameter of the entire aorta. In patients with partial thrombosis of the false lumen, the aneurysm continues to enlarge.
authors.affiliation: Radiologie Vasculaire, Hôpital Cardiologique CHRU Lille, France.
authors.forename: Virginia
authors.initials: V
authors.lastname: Gaxotte
authors.forename: Frédéric
authors.initials: F
authors.lastname: Thony
authors.forename: Hervé
authors.initials: H
authors.lastname: Rousseau
authors.forename: Christophe
authors.initials: C
authors.lastname: Lions
authors.forename: Philippe
authors.initials: P
authors.lastname: Otal
authors.forename: Serge
authors.initials: S
authors.lastname: Willoteaux
authors.forename: Mathieu
authors.initials: M
authors.lastname: Rodiere
authors.forename: Ziad
authors.initials: Z
authors.lastname: Negaiwi
authors.forename: Francis
authors.initials: F
authors.lastname: Joffre
authors.forename: Jean-Paul
authors.initials: JP
authors.lastname: Beregi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D000784:Aortic Dissection / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D001027:Aortography; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000000981:diagnostic imaging; D015607:Stents; D013927:Thrombosis / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome