Endovascular Treatment of Complicated Type-B Aortic Dissection with Stent-Grafts: Midterm Results

Lopera, Jorge E.; Patiño, Jario H.; Urbina, Carlos Lorenzo; García, Giovanni; Álvarez, Luis Guillermo Vélez; Upegui, L; Jhanchai, Akkawat; Qian, Zhenghong; Castañeda-Zúñiga, Wilfrido R.

doi:10.1097/01.rvi.0000058321.82956.76

Cited by 74 publications

(46 citation statements)

References 16 publications

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“…1,2 Goals of stent-graft placement are to reestablish arterial flow to ischemic beds and to abolish pulsatile antegrade perfusion of the false lumen, which should reduce subsequent false lumen enlargement and rupture. [3][4][5][6][7][8] Continued pressurization and perfusion of the false lumen due to endoleak, however, is frequently seen after stent-graft repair of aortic dissection. 9,10 Compared with endoleaks encountered after thoracic endovascular aneurysm repair, endoleak physiology in aortic dissection is complex and incompletely understood.…”

mentioning

confidence: 99%

Factors Portending Endoleak Formation After Thoracic Aortic Stent-Graft Repair of Complicated Aortic Dissection

Sze

Bosch

Dake

et al. 2009

Circ: Cardiovascular Interventions

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Background-Endoleaks after stent-graft repair of aortic dissections are poorly understood but seem substantially different from those seen after aneurysm repair. We studied anatomic and clinical factors associated with endoleaks in patients who underwent stent-graft repair of complicated type B aortic dissections. Methods and Results-From 2000 to 2007, 37 patients underwent stent-graft repair of acute (Յ14 days; nϭ23), subacute (15 to 90 days; nϭ10) or chronic (Ͼ90 days; nϭ4) complicated type B aortic dissections using the Gore Thoracic Excluder (nϭ17) or TAG stent-grafts (nϭ20) under an investigator-sponsored protocol. Endoleaks were classified as imperfect proximal seal, flow through fenestrations or branches, or complex (both). Variables studied included coverage of the left subclavian artery, aortic curvature, completeness of proximal apposition, dissection chronicity, and device used. Endoleaks were found during follow-up (mean, 22 months) in 59% of patients, and they were associated with coverage of the left subclavian artery (complex, PϽ0.001), small radius of curvature (type 1 and complex, Pϭ0.05), and greatest length of unapposed proximal stent graft (complex, PϽ0.0001). During follow-up, 10 endoleaks resolved spontaneously, 6 required reintervention for false lumen dilatation, and 2 were stable without clinical consequences. Conclusions-Endoleaks are common after stent-graft repair of aortic dissection and may lead to false lumen enlargement necessitating reintervention. Anatomic complexities such as acute aortic curvature and covered side branches were associated with endoleaks, illustrating the need for dissection-specific device development.

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confidence: 99%

Factors Portending Endoleak Formation After Thoracic Aortic Stent-Graft Repair of Complicated Aortic Dissection

Sze

Bosch

Dake

et al. 2009

Circ: Cardiovascular Interventions

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“…La terapia endovascular de la disección tipo B aguda si bien resuelve las complicaciones probablemente no sería un tratamiento definitivo derivado de la alta persistencia de falso lumen permeable en la aorta distal 31 .…”

Section: Discussionunclassified

Manejo endovascular de las complicaciones agudas de la disección aórtica tipo B

et al. 2010

Rev. méd. Chile

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“…These criteria included the following: (1) the entry site was at least 0.5 cm distal to the left subclavian artery; (2) there was suitable access to the site, with no aberrant features in the right subclavian artery; (3) the landing zone's diameter was less than 38 mm; and (4) there was no evidence of organ or extremity ischemia, signs of impending rupture, persistent pain, or refractory blood pressure.…”

Section: Patientsmentioning

confidence: 99%

“…With the development of new stent-graft designs and delivery systems, various devices have been developed to adapt to the changing demands among different groups of people and their anatomical characteristics, and clinic practice using these innovative technologies has proven their feasibility. [2][3][4] The encouraging results have led to improvements in the design of stent grafts, which have thus made these devices more reliable.…”

Section: Introductionmentioning

confidence: 96%

Endovascular repair of acute Stanford B-type aortic dissections with domestic stent grafts in China: Early and mid-term results

Liu

Huang

et al. 2011

Surg Today

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Endovascular Treatment of Complicated Type-B Aortic Dissection with Stent-Grafts: Midterm Results

Cited by 74 publications

References 16 publications

Factors Portending Endoleak Formation After Thoracic Aortic Stent-Graft Repair of Complicated Aortic Dissection

Factors Portending Endoleak Formation After Thoracic Aortic Stent-Graft Repair of Complicated Aortic Dissection

Manejo endovascular de las complicaciones agudas de la disección aórtica tipo B

Endovascular repair of acute Stanford B-type aortic dissections with domestic stent grafts in China: Early and mid-term results

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