Treatment of thoracic aortic dissection with stent-grafts: midterm results

J Endovasc Ther. 2002 Dec;9(6):817-21. doi: 10.1177/152660280200900615.

Abstract

Purpose: To evaluate the early and midterm outcomes after stent-graft implantation for dissection in the descending thoracic aorta.

Methods: Sixteen custom-made endovascular stent-grafts were implanted in 15 patients (10 men; mean age 55.9 +/- 13.7 years, range 32-82) with descending thoracic aortic dissection. Indications for stent-graft implantation were persistent symptoms unresponsive to medical treatment or progressive enlargement of the false lumen. Clinical and imaging surveillance with computed tomography was performed within 1 month of the procedure and at 3 to 6-month intervals in follow-up.

Results: Endovascular stent-graft implantation at the target site was successful in 14 (93%) patients; 1 device migrated, leaving the false lumen open to flow in the failed case. One (7%) patient who was treated emergently for rupture died suddenly 2 days after the procedure. Over an average follow-up of 31.5 +/- 23.8 months, 1 (7%) patient died and 2 (14%) patients underwent surgical treatment due to recurrent dissection. The remaining 10 patients showed complete thrombosis of the false lumen; in 3, the false lumen completely resolved.

Conclusions: Endovascular stent-graft implantation in descending thoracic aortic dissection is a feasible, safe, and effective treatment modality. However, further studies are necessary in a greater number of patients to determine if wider application of this minimally invasive procedure is justified.

Publication types

  • Evaluation Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Aneurysm, Dissecting / surgery*
  • Aneurysm, False / surgery
  • Aortic Aneurysm, Thoracic / surgery*
  • Aortic Rupture / surgery
  • Aortography
  • Blood Vessel Prosthesis Implantation
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Postoperative Complications / diagnostic imaging
  • Postoperative Complications / etiology
  • Postoperative Complications / mortality
  • Reoperation
  • Stents*
  • Survival Analysis
  • Syndrome
  • Time Factors
  • Treatment Outcome