Document Detail

Endovascular stent-graft management of aortic intramural hematomas.
MedLine Citation:
PMID:  19398351     Owner:  NLM     Status:  MEDLINE    
PURPOSE: To report initial experience with endovascular stent-grafting in aortic intramural hematoma (IMH). MATERIALS AND METHODS: From 2000 to 2006, 15 patients (mean age, 67 years; range, 54-83 y) underwent endovascular treatment of aortic IMH. Thirteen patients were admitted for acute aortic syndrome and two for traumatic aortic injury. An endovascular procedure was performed as primary treatment for four patients (type A IMH, n = 3; type B IMH, n = 1) and as a second-line therapy in 11 patients because of unfavorable evolution (type A IMH, n = 1; type B IMH, n = 10). All stent-grafts were placed in the descending aorta, even for type A IMH. The mean follow-up was 21 months (range, 6-72 months). RESULTS: The primary success rate was 93%, with complete exclusion of the lesion (n = 14). Exclusion was partial for one patient with a type I endoleak (7%). The 30-day mortality rate was zero. IMH evolution was favorable in all cases, with decreased aortic wall thickening (n = 8) or complete regression (n = 7). Complications associated with endovascular repair were mainly related to aneurysm formation (20%). The late death rate was 7%. CONCLUSIONS: Endovascular stent-graft treatment can be performed in the management of complicated IMH, even in some cases of type A IMH, when an intimal lesion is located in the isthmus or descending aorta with contraindications to surgery. This procedure offers low morbidity and mortality rates, representing a feasible therapeutic option especially for elderly patients with comorbidities. Further studies are necessary to confirm these preliminary results.
Valérie Monnin-Bares; Frédéric Thony; Mathieu Rodiere; Vincent Bach; Rachid Hacini; Dominique Blin; Gilbert Ferretti
Publication Detail:
Type:  Clinical Trial; Journal Article     Date:  2009-04-23
Journal Detail:
Title:  Journal of vascular and interventional radiology : JVIR     Volume:  20     ISSN:  1535-7732     ISO Abbreviation:  J Vasc Interv Radiol     Publication Date:  2009 Jun 
Date Detail:
Created Date:  2009-05-25     Completed Date:  2009-08-05     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9203369     Medline TA:  J Vasc Interv Radiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  713-21     Citation Subset:  IM    
Department of Radiology, Centre Hospitalier Universitaire A. Michallon, Grenoble University 1, La Tronche, BP217, Grenoble 38043, France.
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MeSH Terms
Aged, 80 and over
Aortic Diseases / diagnosis*,  surgery*
Blood Vessel Prosthesis*
Hematoma / diagnosis*,  surgery*
Middle Aged
Treatment Outcome

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