Document Detail


Endovascular treatment of arch and proximal thoracic aortic lesions.
MedLine Citation:
PMID:  18589229     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To analyze at one institution the endovascular treatment for aortic arch and proximal thoracic aortic lesions, categorize open arch reconstruction, and make preliminary recommendations based on pathology (dissection vs aneurysm), and anatomical extent of disease.
METHODS: A retrospective review of aortic arch and descending thoracic aortic lesions managed with endovascular treatment between June 2002 and June 2007.
RESULTS: Thirty-four patients received endovascular repair for aortic dissection (n = 28) and aneurysm (n = 6). Open supra-aortic transposition or debranching of the great vessels was performed in 14 cases of dissection (50%) and six cases (100%) of aneurysm. In 14 dissections, the entry tear was located in the distal aortic arch, enabling the left subclavian artery to be sealed without reconstruction. The procedures were successful in 33 patients (97.1%); one intraoperative death occurred. Type I endoleaks were found intraoperatively in eight cases. After management with balloon angioplasty and by extending the stent implantation, the endoleaks resolved in four cases and decreased in four cases. One patient with Stanford type A dissection died from an unknown cause 3 months after treatment. The overall survival rate was 94.1% (32/34), and all bypass grafts remained patent during the follow-up period.
CONCLUSIONS: Endovascular stent grafting is a safe and effective method for the treatment of aortic arch lesions. Transposition of the supra-aortic great vessels can be effectively combined with endovascular stent grafting to ensure both cerebral blood supply and enough landing area for the stent graft.
Authors:
Shenming Wang; Guangqi Chang; Xiaoxi Li; Zuojun Hu; Songqi Li; Jianyong Yang; Wei Chen; Jiaping Li
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of vascular surgery     Volume:  48     ISSN:  0741-5214     ISO Abbreviation:  J. Vasc. Surg.     Publication Date:  2008 Jul 
Date Detail:
Created Date:  2008-06-30     Completed Date:  2008-08-29     Revised Date:  2012-10-03    
Medline Journal Info:
Nlm Unique ID:  8407742     Medline TA:  J Vasc Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  64-8     Citation Subset:  IM    
Affiliation:
Department of Vascular Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, P.R. China. shenmingwang@vip.sohu.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aneurysm, Dissecting / mortality,  surgery*
Angioplasty, Balloon
Aortic Aneurysm, Thoracic / mortality,  surgery*
Blood Vessel Prosthesis Implantation*
Female
Humans
Male
Middle Aged
Retrospective Studies
Stents
Subclavian Artery / surgery

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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