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Vascular and Interventional Radiology |
1 From the Departments of Radiology I (B.V.C., P.W., A.H.D., R.J.B., W.R.J.) and Vascular Surgery (G.F., K.E.R., R.P.), Leopold-Franzens Medical School and University Hospital Innsbruck, Anichstrasse 35, 6020 Innsbruck, Austria. Received October 28, 1999; revision requested November 24; revision received January 21, 2000; accepted February 1. Address correspondence to B.V.C. (e-mail: benedikt.czermak@uibk.ac.at).
PURPOSE: To evaluate the feasibility and safety of endovascular stent-graft placement in treating Stanford type B aortic dissection.
MATERIALS AND METHODS: Seven patients underwent endovascular stent-graft placement for type B aortic dissection. Five patients had acute and two had chronic dissection. In five patients, the proximal entry tear was within 2 cm of the origin of the left subclavian artery, and in two patients it was beyond this site. In three patients, the noncovered proximal portion of the stent-graft was placed across the origin of the left subclavian artery. The efficacy of the procedure was assessed at follow-up studies 3, 6, 12, and 24 months after intervention.
RESULTS: The procedure was technically and clinically successful in six patients (86%). The left subclavian artery remained patent in all patients. In two patients with involvement of aortic branches, endovascular stent-graft placement restored adequate blood flow to the compromised branches. One patient was readmitted 1 month later because the dissection extended into the ascending aorta. In all but this patient, closure of the entry tear and thrombosis of the false lumen along the stent-graft were achieved. All false lumina shrank considerably. The mean follow-up time was 14 months (range, 1–25 months).
CONCLUSION: Type B aortic dissections within and beyond 2 cm of the origin of the left subclavian artery can be treated safely and effectively by means of endovascular stent-graft placement.
Index terms: Aorta, CT, 942.12915, 942.12916, 943.12915, 943.12916 • Aorta, dissection, 942.743, 943.743 • Interventional procedures, 942.1268, 943.1268 • Stents and prostheses, 942.1268, 943.1268
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