Document Detail


Elective endovascular treatment of descending thoracic aortic aneurysms and chronic dissections with stent-grafts.
MedLine Citation:
PMID:  11340135     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
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:
Type:  Journal Article    
Journal Detail:
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:
Created Date:  2001-05-07     Completed Date:  2001-08-30     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  9203369     Medline TA:  J Vasc Interv Radiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  575-82     Citation Subset:  IM    
Affiliation:
Department of Diagnostic Radiology, Yonsei University College of Medicine, Seodaemun-gu, Seoul, Korea.
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MeSH Terms
Descriptor/Qualifier:
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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