Endovascular treatment for chronic type B dissection: limitations of short stent-grafts revealed at midterm follow-up.
(2009) In Journal of Endovascular Therapy 16(5). p.590-597- Abstract
- PURPOSE: To examine the incidence of and the indications for re-intervention, as well as the changes in aortic morphology, in patients with chronic type B aortic dissection who underwent endovascular intervention for false lumen aneurysms. METHODS: A retrospective analysis was conducted of 10 patients (8 men; mean age 63 years, range 45-79) who underwent stent-graft repair of aneurysmal false lumen expansion related to chronic type B aortic dissection at a median 16 months (range 2-71) from the initial diagnosis. All grafts had been oversized by 10% relative to the normal non-dissected aorta and were implanted to cover the primary entry tear. Follow-up computed tomography scans were analyzed to define changes in aortic morphology. RESULTS:... (More)
- PURPOSE: To examine the incidence of and the indications for re-intervention, as well as the changes in aortic morphology, in patients with chronic type B aortic dissection who underwent endovascular intervention for false lumen aneurysms. METHODS: A retrospective analysis was conducted of 10 patients (8 men; mean age 63 years, range 45-79) who underwent stent-graft repair of aneurysmal false lumen expansion related to chronic type B aortic dissection at a median 16 months (range 2-71) from the initial diagnosis. All grafts had been oversized by 10% relative to the normal non-dissected aorta and were implanted to cover the primary entry tear. Follow-up computed tomography scans were analyzed to define changes in aortic morphology. RESULTS: Mean radiological follow-up was 56 months (median 64.5; range 19-86.5). There was no perioperative mortality or stroke; no cases of aortic rupture were recorded during follow-up. One patient suffered a procedure-related stroke with postoperative hemiparesis following re-intervention for proximal erosion 15 months after the initial treatment. In 6 of the 7 re-interventions performed in 6 patients at a median 42 months after the index procedure, stent-graft extension was required to treat erosion of the dissection membrane that had resulted in endoleak with false lumen reperfusion. The extent of dissection, duration of follow-up, or length of aortic coverage was not predictive of the need for re-intervention during follow-up. At last follow-up, the mean false lumen diameter at the level of the stented aorta was significantly smaller than at baseline (11+/-15 versus 24+/-15 mm, p<0.01). This was associated with false lumen thrombosis at the level of the stent-graft in 9 of 10 cases, although 7 patients had persistent false lumen perfusion distal to the stent-graft. CONCLUSION: Endovascular stent-graft treatment is effective therapy for chronic type B dissection patients with false lumen aneurysms. Erosion of the dissection membrane, causing proximal or distal endoleak, is the most common reason for re-intervention during midterm follow-up. (Less)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/1500186
- author
- Manning, Brian J ; Dias, Nuno LU ; Ohrlander, Thomas ; Malina, Martin LU ; Sonesson, Björn LU ; Resch, Timothy and Ivancev, Krassi LU
- organization
- publishing date
- 2009
- type
- Contribution to journal
- publication status
- published
- subject
- in
- Journal of Endovascular Therapy
- volume
- 16
- issue
- 5
- pages
- 590 - 597
- publisher
- International Society of Endovascular Specialists
- external identifiers
-
- wos:000271308800009
- pmid:19842718
- scopus:71949125356
- pmid:19842718
- ISSN
- 1545-1550
- DOI
- 10.1583/09-2717.1
- language
- English
- LU publication?
- yes
- additional info
- The information about affiliations in this record was updated in December 2015. The record was previously connected to the following departments: Emergency medicine/Medicine/Surgery (013240200), Medical Radiology Unit (013241410)
- id
- a3dad1bf-1688-4d9e-a107-23f75f43a070 (old id 1500186)
- alternative location
- http://www.ncbi.nlm.nih.gov/pubmed/19842718?dopt=Abstract
- date added to LUP
- 2016-04-04 07:07:26
- date last changed
- 2022-02-20 19:57:55
@article{a3dad1bf-1688-4d9e-a107-23f75f43a070, abstract = {{PURPOSE: To examine the incidence of and the indications for re-intervention, as well as the changes in aortic morphology, in patients with chronic type B aortic dissection who underwent endovascular intervention for false lumen aneurysms. METHODS: A retrospective analysis was conducted of 10 patients (8 men; mean age 63 years, range 45-79) who underwent stent-graft repair of aneurysmal false lumen expansion related to chronic type B aortic dissection at a median 16 months (range 2-71) from the initial diagnosis. All grafts had been oversized by 10% relative to the normal non-dissected aorta and were implanted to cover the primary entry tear. Follow-up computed tomography scans were analyzed to define changes in aortic morphology. RESULTS: Mean radiological follow-up was 56 months (median 64.5; range 19-86.5). There was no perioperative mortality or stroke; no cases of aortic rupture were recorded during follow-up. One patient suffered a procedure-related stroke with postoperative hemiparesis following re-intervention for proximal erosion 15 months after the initial treatment. In 6 of the 7 re-interventions performed in 6 patients at a median 42 months after the index procedure, stent-graft extension was required to treat erosion of the dissection membrane that had resulted in endoleak with false lumen reperfusion. The extent of dissection, duration of follow-up, or length of aortic coverage was not predictive of the need for re-intervention during follow-up. At last follow-up, the mean false lumen diameter at the level of the stented aorta was significantly smaller than at baseline (11+/-15 versus 24+/-15 mm, p<0.01). This was associated with false lumen thrombosis at the level of the stent-graft in 9 of 10 cases, although 7 patients had persistent false lumen perfusion distal to the stent-graft. CONCLUSION: Endovascular stent-graft treatment is effective therapy for chronic type B dissection patients with false lumen aneurysms. Erosion of the dissection membrane, causing proximal or distal endoleak, is the most common reason for re-intervention during midterm follow-up.}}, author = {{Manning, Brian J and Dias, Nuno and Ohrlander, Thomas and Malina, Martin and Sonesson, Björn and Resch, Timothy and Ivancev, Krassi}}, issn = {{1545-1550}}, language = {{eng}}, number = {{5}}, pages = {{590--597}}, publisher = {{International Society of Endovascular Specialists}}, series = {{Journal of Endovascular Therapy}}, title = {{Endovascular treatment for chronic type B dissection: limitations of short stent-grafts revealed at midterm follow-up.}}, url = {{http://dx.doi.org/10.1583/09-2717.1}}, doi = {{10.1583/09-2717.1}}, volume = {{16}}, year = {{2009}}, }