title: [Combined use of occluder plus bare stent in the treatment of aortic dissection with tear at the area of visceral branches].
abstract: OBJECTIVE
  To evaluate the novel method of combinedly use of occluder and bare stent in the treatment of aortic dissection with distal tear at visceral branches.
  
  
  METHODS
  From April 2010 to September 2012, 6 patients (5 male and 1 female patients, aged from 29 to 62 years, mean 47.2 years) were diagnosed as Stanford type B aortic dissection that been revealed by CT angiography. The main tears were sealed with stent-grafts firstly, and then the tears at the visceral branch area were evaluated that impossible to close spontaneously. Atrium septal defect occluder and ventricular septal defect were implanted at the tears with the anterior disc in false lumen, while the posterior disc in the true lumen. After that, the bare stents were implanted in the true lumen to pull the occluders on the aortic wall.
  
  
  RESULTS
  Among the 6 procedures, occluders were successfully implanted in 5 cases, and 1 failed anchoring at the tear, and the alternative method of coils embolization was applicated. After all the procedures, the immediate aortogrophy revealed that the false lumen disappeared in the 5 cases that occluders were used, and the visceral branches were all patent. No paraplegia, lesion of visceral organs or other complications occurred. All the cases were followed at least 5 months. There was one endoleak due to a non-sealed tear at the descending aorta, one new-occurred small tear in the descending aorta but with no communication to the false lumen.
  
  
  CONCLUSIONS
  The combinedly use of occluder and bare stent in the treatment of aortic dissection with tears at the visceral branch area is a sum of two simple technique plus each other. It is easily to master. The lesions at the aortic that ordinary stent-grafting incapable to seal are successfully solved then. The huge trauma of open or hybrid procedures are avoided.
authors: Department of Vascular Surgery, 6th Affiliated People's Hospital of Shanghai Jiaotong University, Shanghai 200233, China. Email: junnzhao@126.com.
authors: Jun
authors: J
authors: Zhao
authors: Qing-Sheng
authors: QS
authors: You
authors: Yu-Chun
authors: YC
authors: Zhang
authors: Ji-Hong
authors: JH
authors: Gan
authors: Jia-Cai
authors: JC
authors: Mei
authors: Ming-Zhe
authors: MZ
authors: Shao
authors: Ye
authors: Y
authors: Pan
authors: Jian
authors: J
authors: Zhang
authors: Hai-Sheng
authors: HS
authors: Wu
mesh_terms: D000784:Aortic Dissection / Q000601:surgery; D001014:Aortic Aneurysm / Q000601:surgery; D017545:Aortic Aneurysm, Thoracic / Q000601:surgery; D019917:Blood Vessel Prosthesis Implantation; D006801:Humans; D015607:Stents