Transluminal placement of endovascular stent-grafts for the treatment of type A aortic dissection with an entry tear in the descending thoracic aorta

Kato, Noriyuki; Shimono, Takatsugu; Hirano, Toshio; Ishida, Masaki; Yada, Isao; Takeda, Kan

doi:10.1067/mva.2001.118808

Cited by 96 publications

(72 citation statements)

References 18 publications

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“…Kato et al 21 reported successful stent-graft repair of type A AD with an entry in the descending thoracic aorta. Ishihara et al 22 reported successful one-stage repair of the dissected aorta by interpolating a synthetic graft with a self-expandable stent with only a median sternotomy.…”

Section: Ii-303mentioning

confidence: 99%

Prognosis of Retrograde Dissection From the Descending to the Ascending Aorta

Kaji

Katayama²,

Yamamuro³

et al. 2003

Circulation

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Background-Natural history of aortic dissection (AD) with intimal tear in the descending or abdominal aorta and retrograde extension into the ascending aorta (retrograde AD) remains unknown. The purpose of this study was to elucidate medium-term prognosis of patients with retrograde AD. Methods and Results-Study population consisted of 109 patients with acute type A AD. There were 27 patients (25%) with retrograde AD and 82 patients (75%) with intimal tear in the ascending aorta (antegrade AD). In antegrade AD patients, 60 patients underwent surgery and 22 patients were treated medically. In retrograde AD patients, 14 patients showed localized crescentic high attenuation area along the ascending aortic wall without enhancement in computed tomography. Transesophageal echocardiography revealed complete thrombosis of false lumen (FL) in the ascending aorta (retrograde thrombosed). The remaining 13 patients showed incomplete or no thrombosis (retrograde nonthrombosed). All retrograde nonthrombosed AD patients underwent surgery except for 1 patient with stroke, whereas all retrograde thrombosed AD patients were treated medically. In-hospital mortality rate of retrograde AD patients was significantly lower than that of antegrade AD patients (15% versus 38%, Pϭ0.027). The survival rates in retrograde AD patients were all 85% at 1, 2, and 5 years, which were significantly higher than those of antegrade AD patients (63%, 62%, and 57%, respectively)(Pϭ0.009). Conclusions-Patients

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Section: Ii-303mentioning

confidence: 99%

Prognosis of Retrograde Dissection From the Descending to the Ascending Aorta

Kaji

Katayama²,

Yamamuro³

et al. 2003

Circulation

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“…(13) It has also been proposed that early medical optimisation with controlled use of definitive surgery may be (3) Some authors have suggested that medical therapy may be complimented by early endovascular stenting as an alternative to emergency surgery in selected cases, when there is no evidence of early complication. (14) In summary, the ability to provide early, accurate diagnosis and characterisation for patients with acute aortic dissection is improving, due to earlier access to advanced imaging while patients are still within the emergency department. Radiologists, and residents in particular, should be aware of a lesser-described entity: a retrograde Stanford Type A aortic dissection originating in the descending thoracic aorta.…”

Section: Discussionmentioning

confidence: 99%

Clinics in diagnostic imaging (182)

Gifford

Poh

2017

smedj

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“…Reports on handmade SGs are limited, and the results in these cases are unknown. [15][16][17][18][19][20][21][22][23] In Japan, EVR devices have not been approved as medical devices thus far. Therefore some medical institutions produce their own handmade SGs, and compared with other countries, only a small number of patients undergo this procedure in Japan.…”

Section: Discussionmentioning

confidence: 99%

“…Hence, both the materials used to prepare the SGs and the procedure followed for EVR vary, and the clinical results are influenced by the institutional indications and techniques. 1,[16][17][18][19][20] Our department has been producing and using SGs that comprise stainless steel Z stents and are covered with an ultrathin-wall woven polyester fabric. The initial and midterm results for repair using these handmade SGs for thoracic and abdominal aortic diseases in high-risk patients are considered to be satisfactory.…”

Section: Discussionmentioning

confidence: 99%