title: Simultaneous multi-tear exclusion: an optimal strategy for type B thoracic aortic dissection initially proved by a single center's 8 years experience.
abstract: BACKGROUND
  Endovascular stent-grafting is widely used to treat thoracic aortic dissection. However, little information is available regarding outcome following simultaneous exclusion of multiple tears. This report details eight years of experience using simultaneous multi-tear exclusion for treatment of Stanford type B thoracic aortic dissection resulting in successful aortic remodeling without adverse events.
  
  
  METHODS
  From September 1998 to January 2006, 29 type B thoracic aortic dissection patients (24 men, 5 women; 27 chronic, 2 acute; mean age 58 years, range 45 - 77 years) were treated by simultaneous multi-tear exclusion in our center. Magnetic resonance angiography was used as the preoperative evaluation method. Different kinds of stent-grafts were used. The patients were followed up with contrast-enhanced spiral computed tomography at 6 months postoperatively and yearly thereafter.
  
  
  RESULTS
  Twenty-nine surgeries were completed successfully using at least 2 stent-grafts per patient (range: 2 - 6, mean: 2.7). No major procedure-related complications, such as rupture, paraplegia, aortic branch ischemia or cerebral infarction, were observed. During follow-up, favorable remodeling of the aorta was observed.
  
  
  CONCLUSIONS
  The mid-term result of thoracic aortic dissection with simultaneous multi-tear exclusion was satisfactory. With the improvement of stent-grafts, simultaneous multi-tear exclusion should find wider application and become an optimal strategy for thoracic aortic dissection.
authors.affiliation: Department of Vascular Surgery, Changhai Hospital, Second Military Medical University, Shanghai 200433, China.
authors.forename: Liang-xi
authors.initials: LX
authors.lastname: Yuan
authors.forename: Jun-min
authors.initials: JM
authors.lastname: Bao
authors.forename: Zhi-qing
authors.initials: ZQ
authors.lastname: Zhao
authors.forename: Xiang
authors.initials: X
authors.lastname: Feng
authors.forename: Le-feng
authors.initials: LF
authors.lastname: Ou
authors.forename: Rui
authors.initials: R
authors.lastname: Feng
authors.forename: Qing-sheng
authors.initials: QS
authors.lastname: Lu
authors.forename: Zhi-jun
authors.initials: ZJ
authors.lastname: Mei
authors.forename: Zai-ping
authors.initials: ZP
authors.lastname: Jing
mesh_terms: D000368:Aged; D000784:Aortic Dissection / Q000473:pathology / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000473:pathology / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015607:Stents; D016896:Treatment Outcome