[Endovascular management of acute complications of type B aortic dissection].
BACKGROUND
Type B aortic dissection is usually managed by intensive care medical therapy and surgery is reserved for treating the complications that can occur during the evolution of a case.


OBJECTIVE
To assess the endovascular management of acute complications of type B aortic dissection and the closure of the intimal defect and aortic false lumen.


METHODS
Retrospective analysis of 8 consecutive patients aged 40 to 57 years (seven males) treated for acute complications in the initial episode of a type B aortic dissection between August 2006 and July 2008.


RESULTS
Six/eight were known hypertensive patients. The indications for surgery were intractable pain in one, hypertension refractory to treatment in two and distal hypoperfusion in five. Five patients required covering of the left subclavian artery ostium, without need for surgical repair. One patient was subjected to renal angioplasty and stenting. Technical success was achieved in all cases, with complete closure of the proximal aortic tear and thoracic aortic false lumen, although 7 of patients had a persistent distal aortic false lumen. One case had a transient lower limb paraparesis. No patient died.


CONCLUSIONS
Endovascular treatment is effective in closing the aortic tear as well as the thoracic aortic false lumen in aortic type B dissections with a low complication rate. Due to the high frequency of distal aortic false lumen persistence, it is not a definitive treatment for this condition but it is useful for the acute complications of the initial phase of type B aortic dissection.
Departamento de Cirugía, Clínica Alemana, Santiago de Chile. faibanez@vtr.net
Fernando
F
Ibáñez
Víctor
V
Bianchi
Juan
J
Seitz
Juan
J
Parra
Cristián
C
Salas Del C
Alfredo
A
Arriagada
Felipe
F
Corvalán
Waldo
W
Bastías
Ismael
I
Pizarro
Alfredo
A
Cam
Rodrigo
R
Julio
Juan
J
Herrera
D000328:Adult; D000784:Aortic Dissection / Q000150:complications / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000150:complications / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D057510:Endovascular Procedures / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome; D017539:Tunica Intima / Q000473:pathology / Q000601:surgery