| Elective endovascular treatment of descending thoracic aortic aneurysms and chronic dissections with stent-grafts. | |
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MedLine Citation:
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PMID: 11340135 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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PURPOSE: To report our experience of endovascular stent-graft placement in patients with descending thoracic aortic dissections and aneurysms and to evaluate the feasibility, safety, and clinical outcomes of the treatment. MATERIALS AND METHODS: Stent-grafts were placed in the descending thoracic aortas of 23 patients with saccular aneurysms (n = 11) and Stanford type B chronic aortic dissections of the descending thoracic and abdominal aorta (n = 12). All stent-grafts were individually constructed of self-expandable stainless steel stents covered with polytetrafluoroethylene. Vascular access was achieved through the femoral artery in all patients. Clinical status of each patient was monitored and postoperative CT was performed within 1 month of the procedure and at 3-12-month intervals after the procedures. RESULTS: Successful exclusion of the primary entry tears of dissections and the inlets of saccular aneurysms was achieved in all but two patients with aortic dissection. The overall technical success rate was 91.3% (dissection: 10 of 12 = 83%; aneurysm: 11 of 11 = 100%). All patients in whom technical success was achieved showed complete thrombosis and significant decrease in diameter of the thoracic false lumen (preoperative: 5.3 cm +/- 0.9; postoperative: 4.3 cm +/- 0.9; P = .004) or aneurysm sac (preoperative: 5.3 cm +/- 1.7; postoperative: 2.8 cm +/- 2.5; P = .001). In addition, five patients demonstrated complete resolution of the dissected thoracic false lumen (n = 2) and aneurysm sac (n = 3). However, in all patients with aortic dissection, the abdominal aorta was not significantly changed in size (P = .302) and shape and their false lumen flows remained persistent. Immediate postoperative complications were detected in 12 patients (52%); 10 had fever, leukocytosis, and elevation of C-reactive protein, another had wound infection, and another had transient abdominal pain. Three patients died 2, 3, and 12 months after the procedure: one from septic shock, another from underlying mediastinitis, and the other from an unexplained cause. The remaining 20 patients were well after the procedure (1-9 days; mean, 3 days), without any stent-graft-related complications or discomfort (follow up period: 10-65 mo; mean: 25.1 mo +/- 15.6). The cumulative survival rate after the stent graft was 100% at 30 days and 91% at 12 months. CONCLUSIONS: For treatment of aortic dissection and saccular aneurysm of the descending thoracic aorta, endovascular stent-graft repair may be a technically feasible and effective treatment modality. |
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Authors:
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J Y Won; D Y Lee; W H Shim; B C Chang; S I Park; C S Yoon; H M Kwon; B H Park; G S Jung |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Journal of vascular and interventional radiology : JVIR Volume: 12 ISSN: 1051-0443 ISO Abbreviation: J Vasc Interv Radiol Publication Date: 2001 May |
Date Detail:
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Created Date: 2001-05-07 Completed Date: 2001-08-30 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 9203369 Medline TA: J Vasc Interv Radiol Country: United States |
Other Details:
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Languages: eng Pagination: 575-82 Citation Subset: IM |
Affiliation:
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Department of Diagnostic Radiology, Yonsei University College of Medicine, Seodaemun-gu, Seoul, Korea. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Aneurysm, Dissecting / mortality, surgery* Angiography, Digital Subtraction Aortic Aneurysm, Thoracic / mortality, surgery* Aortography Blood Vessel Prosthesis* Chronic Disease Female Femoral Artery / surgery Humans Male Middle Aged Postoperative Complications Stents* Tomography, X-Ray Computed Treatment Outcome |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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