Endovascular stent graft repair for aneurysms on the descending thoracic aorta

Ehrlich, Marek; Grabenwoeger, Martin; Cartes-Zumelzu, Fabiola; Grimm, Michael; Petzl, D. H.; Lämmer, Johannes; Thurnher, Siegfried; Wolner, Ernst; Havel, Michael

doi:10.1016/s0003-4975(98)00390-7

Cited by 186 publications

(106 citation statements)

References 16 publications

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“…Device 'oversizing' in TBAD patients remains a topic of debate as it is associated with severe complications such as stent-graft-induced new entry tears, retrograde type A dissection, and proximal neck dilatation with subsequent stent-graft migration. [73][74][75][76] In general, oversizing by no more than 0-10% is recommended for patients with TBAD. 74,77 Mis-sizing of the stent-graft can be avoided by keeping in mind the dynamic behavior of the aorta.…”

Section: Endovascular Procedures Tevar (Thoracic Endovascular Aortic mentioning

confidence: 99%

Update in the management of type B aortic dissection

et al. 2016

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Stanford type B aortic dissection (TBAD) is a life-threatening aortic disease. The initial management goal is to prevent aortic rupture, propagation of the dissection, and symptoms by reducing the heart rate and blood pressure. Uncomplicated TBAD patients require prompt medical management to prevent aortic dilatation or rupture during subsequent follow-up. Complicated TBAD patients require immediate invasive management to prevent death or injury caused by rupture or malperfusion. Recent developments in diagnosis and management have reduced mortality related to TBAD considerably. In particular, the introduction of thoracic stent-grafts has shifted the management from surgical to endovascular repair, contributing to a fourfold increase in early survival in complicated TBAD. Furthermore, endovascular repair is now considered in some uncomplicated TBAD patients in addition to optimal medical therapy. For more challenging aortic dissection patients with involvement of the aortic arch, hybrid approaches, combining open and endovascular repair, have had promising results. Regardless of the chosen management strategy, strict antihypertensive control should be administered to all TBAD patients in addition to close imaging surveillance. Future developments in stent-graft design, medical therapy, surgical and hybrid techniques, imaging, and genetic screening may improve the outcomes of TBAD patients even further. We present a comprehensive review of the recommended management strategy based on current evidence in the literature.

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Section: Endovascular Procedures Tevar (Thoracic Endovascular Aortic mentioning

confidence: 99%

Update in the management of type B aortic dissection

et al. 2016

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“…Overall, successful device deployment is achieved in 85% to 100% of cases, and periprocedural mortality ranges from 0% to 14%, falling within or below elective surgery mortality rates of 5% to 20%. 68,[75][76][77][78][79][80][81][82][83][84][85][86][87][88][89][90] As expected, outcomes have improved over time with accumulated technical expertise, use of commercially manufactured devices, and improved patient selection criteria. The recently published collective experiences of the EUROSTAR and United Kingdom Thoracic Endograft registries, the largest series to date (nϭ249), demonstrate successful deployment in 87% of cases, 30-day mortality of 5% for elective cases, and paraplegia and endoleak rates of 4%.…”

Section: Clinical Experiencementioning

confidence: 99%

“…In a similar study, Ehrlich and colleagues found decreased 30-day mortality (10% versus 31%), mean hospital stay (6 versus 10 days), and mean intervention time (150 versus 325 minutes) in the endovascular group; the paraplegia rate was also decreased (0% versus 12%). 76 …”

Section: Clinical Experiencementioning

confidence: 99%

Endovascular Repair of Abdominal and Thoracic Aortic Aneurysms

et al. 2005

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“…Since then, many authors (20,21) have demonstrated the technical feasibility of this technique. In addition to aneurysms, a wide variety of diseases of the thoracic aorta have been treated with thoracic stent grafts: blunt traumatic aortic ruptures, complicated penetrating ulcers, acute and chronic type B dissections, mycotic aneurysms, iatrogenic aortic ruptures and other miscellaneous diseases (22)(23)(24)(25). Procedural success rates are greater than 95%, while in-hospital mortality is mainly linked to the severity of the patient's comorbidities (26,27).…”

Section: Thoracic Stent Graftingmentioning

confidence: 99%