Nonsurgical Reconstruction of Thoracic Aortic Dissection by Stent–Graft Placement

Nienaber, C.A.; Fattori, Rossella; Lund, Gunnar; Dieckmann, Christoph; Wolf, W; Kodolitsch, Yskert Von; Nicolas, Volkmar; Pierangeli, A

doi:10.1056/nejm199905203402003

Cited by 954 publications

(667 citation statements)

References 30 publications

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“…Resultados preliminares indicam que o uso de stents nas dissecções complicadas tipo B é mais seguro e carreia riscos menores quando realizados por via percutânea, em relação ao implante por cirurgia aberta 92 95 .…”

Section: Recomendaçõesunclassified

Diretrizes para a cirurgia das doenças da aorta

Albuquerque¹,

Palma²,

Braile³

et al. 2004

Arq. Bras. Cardiol.

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Section: Recomendaçõesunclassified

Diretrizes para a cirurgia das doenças da aorta

Albuquerque¹,

Palma²,

Braile³

et al. 2004

Arq. Bras. Cardiol.

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“…El objetivo del implante de una endoprótesis en las disecciones es cerrar el desgarro proximal de la aorta, redireccionando el flujo por el lumen verdadero, lo que promovería la trombosis del falso lumen y la remodelación aórtica con menor morbimortalidad que la cirugía convencional 16,17 .…”

Section: Discussionunclassified

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

et al. 2010

Rev. méd. Chile

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“…In a small retrospective analysis, Nienaber et al 64 found that, among patients with type B AAD, stentgraft recipients had lower morbidity and mortality than patients requiring surgery. Another study found that death among patients who underwent stent-graft placement was rarely directly related to the endovascular procedure but rather due to nonreversible ischemic changes compounded by patients' comorbid conditions.…”

Section: Endovascular Therapy For Acute Aortic Syndromesmentioning

confidence: 99%

“…The unadjusted survival rate ± SD at 1 and 3 years for patients was 90.3%±4.3% and 77.6%±6.6% for medical therapy alone, 95.8%±8.0% and 82.8%±18.9% for surgery, and 88.9%±11.9% and 76.2%±25.2% for endovascular repair ( Figure 9). 74 Nienaber et al 64 prospectively compared 24 patients with thoracic AADs who underwent either endovascular stent-graft placement or open surgery. Recipients of surgical repair had significantly longer hospital stays (mean ± SD, 40±24 days vs 7±3 days), including longer stays in the ICU, and significantly more cumulative morbidity, including paraplegia, neurologic deficits, respiratory complications, and renal failure ( Table 2).…”

Section: Acute Aortic Syndromesmentioning

confidence: 99%

Acute Aortic Syndromes and Thoracic Aortic Aneurysm

Ramanath

Sundt

et al. 2009

Mayo Clinic Proceedings

190

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Acute and chronic aortic diseases have been diagnosed and studied by physicians for centuries. Both the diagnosis and treatment of aortic diseases have been steadily improving over time, largely because of increased physician awareness and improvements in diagnostic modalities. This comprehensive review discusses the pathophysiology and risk factors, classification schemes, epidemiology, clinical presentations, diagnostic modalities, management options, and outcomes of various aortic conditions, including acute aortic dissection (and its variants intramural hematoma and penetrating aortic ulcers) and thoracic aortic aneurysms. Literature searches of the PubMed database were conducted using the following keywords: aortic dissection, intramural hematoma, aortic ulcer, and thoracic aortic aneurysm. Retrospective and prospective studies performed within the past 20 years were included in the review; however, most data are from the past 15 years. and studied by physicians for centuries. Descriptions of such pathologic conditions of the aorta as aneurysm and dissection date back as early as the 2nd century during the time of Galen, whose discoveries were largely made through studies of apes. More "recent" reports were described by Vesalius in 1557, followed by Nichols in 1732, who detailed the process of aortic dissection. In 1761, Morgagni reported detailed pathologic features of a patient with a ruptured aorta. 1 However, our true understanding of aortic pathology began with the dissertation by Shennan 2 in 1934, which included a description of penetrating atheromatous plaques of the thoracic aorta. His report was followed by the first successful management of aortic dissection by DeBakey in 1955. 1 Since then, our knowledge of the pathologic conditions of the aorta has grown considerably and continues to evolve with ongoing research into the pathophysiology of these conditions, technological advances in the modes of detection, and improved therapeutic options. Clinical databases, such as the International Registry of Acute Aortic Dissection (IRAD), the largest current registry for acute aortic syndromes, have also contributed tremendously to our knowledge of acute aortic pathology.For the practicing clinician, knowledge of aortic disease is paramount because patients with aortic conditions contribute significantly to the overall mortality from cardiovascular disease. This review discusses the pathophysiology, epidemiology, presentation, diagnosis, and therapeutic options for several forms of acute and chronic aortic pathology: aortic dissection (including its variants intramural hematoma [IMH] and penetrating atheromatous aortic ulcer) and thoracic aortic aneurysm (TAA). Literature searches were performed of the PubMed database using the following key words: aortic dissection, intramural hematoma, aortic ulcer, and thoracic aortic aneurysm. Retrospective and prospective studies conducted within the past 15 years, along with some data from years prior, were included in this review.

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Nonsurgical Reconstruction of Thoracic Aortic Dissection by Stent–Graft Placement

Cited by 954 publications

References 30 publications

Diretrizes para a cirurgia das doenças da aorta

Diretrizes para a cirurgia das doenças da aorta

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

Acute Aortic Syndromes and Thoracic Aortic Aneurysm

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