Simultaneous multi-tear exclusion: an optimal strategy for type B thoracic aortic dissection initially proved by a single center's 8 years experience.
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.
Yuan
Liang-xi
LX
Department of Vascular Surgery, Changhai Hospital, Second Military Medical University, Shanghai 200433, China.
Bao
Jun-min
JM
Zhao
Zhi-qing
ZQ
Feng
Xiang
X
Ou
Le-feng
LF
Feng
Rui
R
Lu
Qing-sheng
QS
Mei
Zhi-jun
ZJ
Jing
Zai-ping
ZP
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