| True-lumen collapse in aortic dissection: part II. Evaluation of treatment methods in phantoms with pulsatile flow. | |
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MedLine Citation:
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PMID: 10644107 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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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:
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Type: Journal Article |
Journal Detail:
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Title: Radiology Volume: 214 ISSN: 0033-8419 ISO Abbreviation: Radiology Publication Date: 2000 Jan |
Date Detail:
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Created Date: 2000-01-28 Completed Date: 2000-01-28 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0401260 Medline TA: Radiology Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 99-106 Citation Subset: AIM; IM |
Affiliation:
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Division of Cardiovascular-Interventional Radiology, Stanford University Medical Center, Stanford Vascular Center, CA 94304-5105, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aneurysm, Dissecting
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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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