Endovascular aortic repair combined with chimney technique in the treatment of stanford type B aortic dissection involving aortic arch.
BACKGROUND
In this study, we sought to explore the efficacy of endovascular aortic repair combined with the chimney technique in the treatment of Stanford type B aortic dissection involving the aortic arch.


METHODS
Between June 2009 and June 2012, 41 consecutive patients were treated with chimney technique at our institute for aortic arch dissection with the primary entry tear adjacent to the orifices of the supra-aortic arteries. The chimney technique was used to reconstruct the left subclavian artery (n = 5) and the left common carotid artery (n = 34). Additionally, in 2 cases, the double chimney technique was used to simultaneously reconstruct the innominate artery and the left common carotid artery.


RESULTS
Eight of the 41 patients had undergone emergent surgery. All the patients survived the surgery, and the mean follow-up period was 17.3 ± 6.1 months. None of the patients had type I endoleak. Four patients had type II endoleak, and 3 of them underwent implantation of the patent ductus arteriosus occluder in the left subclavian artery. Among these 3 patients, one patient who was pregnant with Marfan syndrome and pregnancy-induced hypertension required additional medication for recovery. None of the patients had any severe neurological complications, left ischemia of the subclavian artery, migration of the stent graft, or occlusion of the stent grafts.


CONCLUSIONS
Thus, endovascular aortic repair combined with the chimney technique appears to be a feasible, safe, and effective treatment option for the management of Stanford type B aortic dissection involving the aortic arch.
Department of Vascular Surgery, Second Xiangya Hospital, Central South University, Changsha, China; Department of Vascular Surgery, Tianjin People's Hospital, Tianjin, China; Department of Vascular Surgery, Tianjin People's Hospital of Tianjin Medical University, Tianjin, China.
Hong
H
Liu
Department of Vascular Surgery, Second Xiangya Hospital, Central South University, Changsha, China. Electronic address: changshu01@yahoo.com.
Chang
C
Shu
Department of Vascular Surgery, Second Xiangya Hospital, Central South University, Changsha, China.
Xin
X
Li
Department of Vascular Surgery, Second Xiangya Hospital, Central South University, Changsha, China.
Tun
T
Wang
Department of Vascular Surgery, Second Xiangya Hospital, Central South University, Changsha, China.
Ming
M
Li
Department of Vascular Surgery, Second Xiangya Hospital, Central South University, Changsha, China.
Quan-Ming
QM
Li
Department of Vascular Surgery, Second Xiangya Hospital, Central South University, Changsha, China.
Kun
K
Fang
Department of Vascular Surgery, Second Xiangya Hospital, Central South University, Changsha, China.
Shalong
S
Wang
D000328:Adult; D000784:Aortic Dissection / Q000175:diagnosis / Q000601:surgery*; D015901:Angiography, Digital Subtraction; D017545:Aortic Aneurysm, Thoracic / Q000175:diagnosis / Q000601:surgery*; D001027:Aortography / Q000379:methods; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D002681:China; D057510:Endovascular Procedures / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis / Q000628:therapy; D011247:Pregnancy; D015607:Stents; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome