title: [Endovascular stent-graft treatment for DeBakey I aortic dissection].
abstract: OBJECTIVE
  To study endovascular treatment of DeBakey type I aortic dissecting aneurysm.
  
  
  METHODS
  Seven patients with DeBakey I aortic dissecting aneurysms were treated. Diagnoses were confirmed by MRA, CT and angiography. The intimal tear entry was in the ascending aorta, 2.5 approximately 6.0 cm from the ostia of the coronary arteries, and 0.5 approximately 4.0 cm from the brachiocephalic trunk opening. Endovascular stent-grafts were deployed via a left common carotid artery (LCCA) approach in 2 cases and right femoral artery (RFA) approach in 5 cases. Prior to treatment, a left subclavicular artery (LSA)-LCCA shunt was established to ensure blood supply to the LCCA during surgery in 2 cases via LCCA approach, and a LSA-LCCA-right common carotid artery (RCCA) synthetic bypass was established to ensure blood supply to the brain in 2 cases in RFA approach.
  
  
  RESULTS
  The operative success rate was 100%. In 3 cases, endoleak persisted after the first stent was placed, but this was eliminated by placement of a second stent. All patients survived except one who died of acute massive hemorrhage from the upper gastrointestinal tract one month postoperatively. The false lumen in all 6 cases became thrombosed and no endoleak or new aortic dissecting aneurysms developed.
  
  
  CONCLUSIONS
  Endovascular treatment of DeBakey type I aortic dissecting aneurysm is feasible, minimally invasive, and effective. Case selection depends on the distance of the coronary artery ostia from the tear entry.
authors.affiliation: Department of Vascular Surgery, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China.
authors.forename: Guang-qi
authors.initials: GQ
authors.lastname: Chang
authors.forename: Shen-ming
authors.initials: SM
authors.lastname: Wang
authors.forename: Xiao-xi
authors.initials: XX
authors.lastname: Li
authors.forename: Zuo-jun
authors.initials: ZJ
authors.lastname: Hu
authors.forename: Chen
authors.initials: C
authors.lastname: Yao
authors.forename: Heng-hui
authors.initials: HH
authors.lastname: Yin
authors.forename: Jian-yong
authors.initials: JY
authors.lastname: Yang
authors.forename: Wei
authors.initials: W
authors.lastname: Chen
authors.forename: Jia-ping
authors.initials: JP
authors.lastname: Li
mesh_terms: D000328:Adult; D000368:Aged; D000784:Aortic Dissection / Q000601:surgery*; D001014:Aortic Aneurysm / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D015607:Stents; D016896:Treatment Outcome