| Midterm results after endovascular treatment of acute, complicated type B aortic dissection. | |
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MedLine Citation:
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PMID: 20971237 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: The purpose of this study was to assess the efficacy and midterm results of endovascular treatment of acute, complicated type B aortic dissection. METHODS: Between January 2001 and February 2010, 32 patients (7 women, 25 men) with acute, complicated type B aortic dissection (mean age, 56 years; range, 35 to 83 years), defined as either aortic rupture, malperfusion, intractable pain, or uncontrolled hypertension, underwent endovascular stent graft placement with either the Gore Excluder/TAG device (n = 11), Medtronic Talent/Valiant device (n = 16), Bolton Relay (n = 2), or a combination of these stents (n = 3). Follow-up was 94% complete and averaged 26 ± 23 months. RESULTS: Technical feasibility and success with deployment proximal to the entry tear was 87%, requiring partial or total coverage of the left subclavian artery (LSA) in 9 patients (28%). Hospital mortality was 12% ± 11% (95% confidence limit) with 2 late deaths (17 and 98 months after implant). Causes of hospital death included rupture in 2, retrograde type A dissection in 1, and multiorgan failure in 1 patient. Three patients (11%) experienced new neurologic complications (2 paraparesis and 1 hemiparesis). Six patients with malperfusion required branch vessel stenting. Furthermore, 2 had an early type Ia endoleak. Actuarial survival at 1 and 5 years was 81% and 76%, respectively. Freedom from treatment failure at 1 and 5 years (including reintervention, aortic rupture, device-related complication, and aortic related death) was 78% and 61%, respectively. CONCLUSIONS: Endovascular stent-graft placement in acute, complicated type B aortic dissection proves to be a promising alternative therapeutic treatment modality in this relatively difficult patient cohort. Refinements, especially in stent design and application, may further improve the prognosis of patients in this life-threatening situation. |
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Authors:
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Marek P Ehrlich; Julia Dumfarth; Maria Schoder; Roman Gottardi; Johannes Holfeld; Andrzej Juraszek; Tomasz Dziodzio; Martin Funovics; Christian Loewe; Michael Grimm; Gottfried Sodeck; Martin Czerny |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: The Annals of thoracic surgery Volume: 90 ISSN: 1552-6259 ISO Abbreviation: Ann. Thorac. Surg. Publication Date: 2010 Nov |
Date Detail:
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Created Date: 2010-10-25 Completed Date: 2010-11-10 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 15030100R Medline TA: Ann Thorac Surg Country: Netherlands |
Other Details:
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Languages: eng Pagination: 1444-8 Citation Subset: AIM; IM |
Copyright Information:
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Copyright © 2010 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved. |
Affiliation:
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Department of Cardiothoracic Surgery, Division of Cardiovascular and Interventional Radiology, University of Vienna, Vienna, Austria. marek.ehrlich@meduniwien.ac.at |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Acute Disease Adult Aged Aged, 80 and over Aneurysm, Dissecting / mortality, surgery* Aorta, Thoracic / surgery* Aortic Aneurysm, Thoracic / mortality, surgery* Blood Vessel Prosthesis Implantation / methods* Female Follow-Up Studies Hospital Mortality Humans Male Middle Aged |
| Comments/Corrections | |
Comment In:
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Ann Thorac Surg. 2010 Nov;90(5):1448-9
[PMID:
20971238
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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