Endovascular stent-graft placement of aneurysms involving the descending aorta originating from chronic type B dissections.
BACKGROUND
The performance of endovascular stent-graft placement in patients suffering from aneurysms involving the descending aorta originating from chronic type B dissections is unclear.


METHODS
Within a 2-year period, we treated 6 patients with this pathology. Four patients required extension of the proximal landing zone (autologous double transposition, n = 2; subclavian-to-carotid artery transposition, n = 2) before stent-graft placement.


RESULTS
Supra-aortic rerouting procedures and endovascular stent-graft placement were performed successfully in all patients. Closure of the primary entry tear, full expansion of the stent-graft, and eventually, thrombosis of the false lumen was achieved in 5 patients. In 1 patient with a short proximal landing zone, a persisting type Ia endoleak was observed. In all patients with successful primary entry closure, a reduction in aneurysm diameter occurred. Mean follow-up is 16 months (range, 4 to 25).


CONCLUSIONS
Endovascular stent-graft placement of aneurysms involving the descending aorta originating from chronic type B dissections may serve as a valuable treatment option in this complex pathology. The chronic dissection membrane can be successfully compressed against large areas of the native aortic wall. A sufficient proximal landing zone is mandatory for early and late success.
Czerny
Martin
M
Department of Cardiothoracic Surgery, University of Vienna Medical School, Vienna, Austria. martin.czerny@meduniwien.ac.at
Zimpfer
Daniel
D
Rodler
Suzanne
S
Funovics
Martin
M
Dorfmeister
Marion
M
Schoder
Maria
M
Marta
Gabriel
G
Weigang
Ernst
E
Gottardi
Roman
R
Lammer
Johannes
J
Wolner
Ernst
E
Grimm
Michael
M
D000368:Aged; D000784:Aortic Dissection / Q000150:complications / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000209:etiology / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D002908:Chronic Disease; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015607:Stents