<b>Elective Stent-Graft Treatment of Aortic Dissections</b>

Lee, Kwang-Hun; Won, Jong Yun; Lee, Do Yun; Choi, Donghoon; Shim, Won-Heum; Chang, Byung Chul

doi:10.1583/1220mr.1

Cited by 27 publications

(25 citation statements)

References 31 publications

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“…3,16,18,22,26 Interestingly, it was also observed in our center that post-stent grafting RTAD represented the most common complication among Marfan patients. In total, we have performed endografting in 6 type B dissections with Marfan syndrome, of whom 4 had solitary type B dissection and 2 previously underwent the Bentall procedure for type A dissection.…”

Section: Discussionmentioning

confidence: 56%

“…In patient 10, the aortic wall was injured by pushing forward the partially released stent graft. RTAD in 2 patients presented by Won et al 3 and Lee et al 18 was attributed to guidewire-induced injury. Balloon inflation also could cause injury on the wall, particularly when the stent graft is attached proximally on the already involved aorta.…”

Section: Dong Et Al Poststent Grafting Retrograde Type a Dissectionmentioning

confidence: 89%

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Retrograde Type A Aortic Dissection After Endovascular Stent Graft Placement for Treatment of Type B Dissection

et al. 2009

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Background-Retrograde type A aortic dissection has been deemed a rare complication after endovascular stent graft placement for type B dissection. However, this life-threatening event appears to be underrecognized and is worth being investigated further. Methods and Results-Eleven of 443 patients developed retrograde type A aortic dissection during or after stent grafting for type B dissection from August 2000 to June 2007. Of these 11 patients, 3 had Marfan syndrome. The Kaplan-Meier estimate of the rate of freedom from this event at 36 months is 97.4% (95% confidence interval, 0.95 to 0.99). The new entry was located at the tip of the proximal bare spring of the stent graft in 9 patients, was within the anchoring area of the proximal bare spring in 1, and remained unknown in 1 patient. Eight patients were converted to open surgery, and 2 received medical treatment. One patient suddenly died 2 hours after the primary stent grafting, and 2 died within 1 week after the surgical conversion, so mortality reached 27.3%. During the follow-up from 3 to 50 months, type I endoleak was identified in 1 patient 3 months after the surgical exploration and disappeared at 6 months. Conclusions-Retrograde type A aortic dissection after stent grafting for type B dissection appears not to be rare and results from mixed causes. Fragility of the aortic wall and disease progression may predispose to it, whereas stent grafting-related factors make important and provocative contributions. Avoiding aortic arch stent grafting in Marfan patients, preferably selecting the endograft without the proximal bare spring for patients with a kinked aortic arch or with Marfan syndrome (if endografting is used), improving the device design, and standardizing endovascular manipulation might lessen its occurrence.

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Section: Discussionmentioning

confidence: 56%

Section: Dong Et Al Poststent Grafting Retrograde Type a Dissectionmentioning

confidence: 89%

Retrograde Type A Aortic Dissection After Endovascular Stent Graft Placement for Treatment of Type B Dissection

et al. 2009

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“…Blood flow through atherosclerotic vessels is restored by balloon angioplasty and/or stent implantation, but vessel patency is frequently short-lived. In a process termed intimal hyperplasia, proliferating smooth muscle cells grow radially inward to re-occlude the vessel, which results in a clinical failure phenomena termed restenosis (Lee et al, 2004).…”

Section: Introductionmentioning

confidence: 99%

Increased endothelial cell adhesion on plasma modified nanostructured polymeric and metallic surfaces for vascular stent applications

Pareta

Reising

Miller³

et al. 2009

Biotech & Bioengineering

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Techniques to regenerate the vasculature have risen considerably over the last few decades due to the increased clinical diagnosis of artery narrowing and blood vessel blockage. Although initially re-establishing blood flow, current small diameter vascular regenerative materials often eventually cause thrombosis and restenosis due to a lack of initial endothelial cell coverage on such materials. The objective of this in vitro study was to evaluate commonly used vascular materials (specifically, polyethylene terephthalate, polytetrafluoroethylene, polyvinyl chloride, polyurethane, nylon, commercially pure titanium, and a titanium alloy (Ti6Al4V)) modified using an ionic plasma deposition (IPD) process and a nitrogen ion implantation plasma deposition (NIIPD) process. Such surface modifications have been previously shown to create nanostructured surface features which mimic the natural nanostructured surface features of blood vessels. The modified and unmodified surfaces were characterized by scanning electron microscopy, atomic force microscopy and surface energy measurements. Furthermore, in vitro endothelial cell adhesion tests (a key first step for vascular material endothelialization) demonstrated increased endothelial cell adhesion on many modified (with IPD and NIIPD + IPD) compared to unmodified samples. In general, endothelial cell adhesion increased with nanoroughness and surface energy but demonstrated a decreased endothelial cell adhesion trend after an optimal coating surface energy value was reached. Thus, results from this study provided materials and a versatile surface modification process that can potentially increase endothelialization faster than current unmodified (conventional) polymer and metallic vascular materials.

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“…Endovascular techniques are now available for treatment of aortic aneurysm and aortic dissection using various stentgraft systems [1][2][3][4][5][6]. This has clearly been shown to decrease operative morbidity, patient discomfort, hospital stay, intensive care unit stay, blood loss, and recovery time.…”

Section: Introductionmentioning

confidence: 99%

Percutaneous closure of femoral artery access sites in endovascular stent-graft treatment of aortic disease

Shim¹,

Park²,

Ko³

et al. 2008

International Journal of Cardiology

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Elective Stent-Graft Treatment of Aortic Dissections

Abstract: Stent-graft treatment is a feasible and effective treatment modality in aortic dissection. However, close follow-up is mandatory to monitor new intimal tear, saccular aneurysms, or enlargement of the abdominal aortic false lumen.

Cited by 27 publications

References 31 publications

Retrograde Type A Aortic Dissection After Endovascular Stent Graft Placement for Treatment of Type B Dissection

Retrograde Type A Aortic Dissection After Endovascular Stent Graft Placement for Treatment of Type B Dissection

Increased endothelial cell adhesion on plasma modified nanostructured polymeric and metallic surfaces for vascular stent applications

Percutaneous closure of femoral artery access sites in endovascular stent-graft treatment of aortic disease

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