of acute aortic dissections with balloon catheter to closeDespite recent advances in medical treatment, an acute aortic dissection is still now often fatal because of the seriousness of its condition. The currently available therapies include blocking the progress of dissection with intensive drug therapy, a process leading to the chronic stage. However, the dissection often proceeds rapidly and may result in death. Various surgical procedures have been attempted so far, but they produce highly invasive stress and high risks. Accordingly, we designed a cylinder-type balloon catheter and developed a new closing procedure, wherein a balloon catheter is introduced and inflated at the site with an intimal tear to maintain the blood flow to the distal vessels and also to close the entry. With this procedure, the complaints will be relieved or disappear, the progress of the dissection can be stopped, and the blood flow can be restored to the reduced and collapsed true lumen. When the blood in the pseudolumen becomes coagulated and organized, the balloon is removed. If this catheter is introduced from the femoral artery (similar to an intra-aortic balloon pumping method), the invasive stress will be further reduced. This method appears to be the most useful for DeBakey type III dissections. We are now intensively studying the safe and effective application of this balloon catheter under various clinical conditions.
We have developed a nonporous, 3‐layered laminated vascular prosthesis made of a new nonwoven cloth. Examination of its physical properties and stress relaxation curve showed that the new prosthesis is strong enough to be used as a vascular substitute and compares favorably with human arteries. Animal experiments showed that the nonporosity of the prosthesis did not adversely affect neointima formation. The prosthesis was implanted in the abdominal aorta of 70 dogs for up to 6 years and had a patency rate of 94.3%. The grafts remained elastic and pliable without aneurysmal dilatation even after prolonged use. Studies using light microscopy and scanning electron microscopy showed that a thin, smooth neointima was formed on the inner surface of the prosthesis. The velourlike surface structure of the nonwoven cloth appeared to form a good foundation for deposition of fibrin and formation of the neointima. On the basis of our encouraging experimental results, we have used the new prosthesis for reconstruction of the peripheral arteries in 10 patients, but the followup period has been too short for proper evaluation.
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