title: Pregnancy-associated type B aortic dissection treated with thoracic endovascular aneurysm repair.
abstract: BACKGROUND
  The purpose of this study was to report our early experience with thoracic endovascular aneurysm repair as a treatment for late pregnancy-associated aortic dissection.
  
  
  METHODS
  We retrospectively reviewed the records and imaging data of 4 consecutive patients who were diagnosed with acute aortic dissection. All 4 patients were diagnosed during the third trimester or early postpartum period, and all of them were treated with thoracic endovascular aneurysm repair either before or after delivery; adjunctive endovascular procedures included balloon dilation of aortic coarctations and insertion of a snorkel stent into the left common carotid artery. All mothers and children were followed by outpatient observation; mothers had surveillance with computed tomography angiography at 1, 3, and 6 months and then yearly.
  
  
  RESULTS
  Technical success was 100%, with coverage of the primary tear sites in all 4 cases. The left subclavian artery was covered in 3 patients. During follow-up there were no type I endovascular leaks or stent migrations; type II endovascular leak was detected in 1 patient who required a left common carotid artery snorkel stent, and this endovascular leak disappeared at 11 months. All mothers and children survived the perinatal period and showed no major adverse outcomes during follow-up of 17.5 months.
  
  
  CONCLUSIONS
  Short and midterm results of thoracic endovascular aneurysm repair for complicated type B aortic dissection in late trimester and early postpartum period are satisfying in this series. Indications for and timing of procedure relative to delivery should be determined cautiously by clinical urgency.
authors.affiliation: Department of Vascular Surgery, Second Xiangya Hospital of Central South University, Changsha, China. Electronic address: changshu0101@gmail.com.
authors.forename: Chang
authors.initials: C
authors.lastname: Shu
authors.affiliation: Department of Vascular Surgery, Second Xiangya Hospital of Central South University, Changsha, China.
authors.forename: Kun
authors.initials: K
authors.lastname: Fang
authors.affiliation: Department of Surgery and Interdepartmental Program in Vascular Biology and Therapeutics, Yale University School of Medicine, New Haven, Connecticut.
authors.forename: Alan
authors.initials: A
authors.lastname: Dardik
authors.affiliation: Department of Vascular Surgery, Second Xiangya Hospital of Central South University, Changsha, China.
authors.forename: Xin
authors.initials: X
authors.lastname: Li
authors.affiliation: Department of Vascular Surgery, Second Xiangya Hospital of Central South University, Changsha, China.
authors.forename: Ming
authors.initials: M
authors.lastname: Li
mesh_terms: D000328:Adult; D000784:Aortic Dissection / Q000145:classification / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000145:classification / Q000601:surgery*; D057510:Endovascular Procedures / Q000379:methods; D005260:Female; D006801:Humans; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000601:surgery*; D012189:Retrospective Studies; D019616:Thoracic Surgical Procedures; D055815:Young Adult
keywords: 26