Document Detail


True-lumen collapse in aortic dissection: part II. Evaluation of treatment methods in phantoms with pulsatile flow.
MedLine Citation:
PMID:  10644107     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To discover and evaluate the effective treatment methods to prevent or relieve true-lumen collapse in models of aortic dissection. MATERIALS AND METHODS: Two phantoms were built to simulate type B aortic dissection. After true-lumen collapse was induced, experiments were conducted to evaluate the effectiveness of clinically relevant variables in relieving the collapse. Variables included entry-tear size, branch-vessel flow distribution, distal reentry communication between the true and false limbs, aortic fenestrations, and pump output. To test the effect of closing the entry tear, a stent-graft was deployed over the entry tear under physiologic conditions in a mock-flow loop. The difference in the effect of each variable on the prevention and relief of true-lumen collapse was also investigated. RESULTS: It was more difficult to relieve true-lumen collapse than it was to prevent it. Placement of a stent-graft over the entry tear was the most effective method of relieving true-lumen collapse. Less-effective procedures included opening a false-lumen outflow branch and opening the distal reentry branch. Opening the fenestration-branch loops, meant to simulate the creation of artificial fenestrations in the intimal flap, did not relieve true-lumen collapse. CONCLUSION: The definitive treatment for true-lumen collapse in aortic dissection is direct repair of the entry tear to decrease false-lumen inflow. Otherwise, increasing the false-lumen outflow and/or creating distal fenestrations between the true and false lumina distal to the level of the compromised aortic branch are less-effective alternatives.
Authors:
J W Chung; C Elkins; T Sakai; N Kato; T Vestring; C P Semba; S M Slonim; M D Dake
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Radiology     Volume:  214     ISSN:  0033-8419     ISO Abbreviation:  Radiology     Publication Date:  2000 Jan 
Date Detail:
Created Date:  2000-01-28     Completed Date:  2000-01-28     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0401260     Medline TA:  Radiology     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  99-106     Citation Subset:  AIM; IM    
Affiliation:
Division of Cardiovascular-Interventional Radiology, Stanford University Medical Center, Stanford Vascular Center, CA 94304-5105, USA.
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MeSH Terms
Descriptor/Qualifier:
Aneurysm, Dissecting / physiopathology,  therapy*
Aortic Aneurysm / physiopathology,  therapy*
Blood Vessel Prosthesis Implantation
Hemodynamics / physiology
Humans
Models, Cardiovascular*
Phantoms, Imaging*
Pulsatile Flow / physiology*
Stents
Treatment Outcome

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


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