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[Minimally invasive therapy options in aortic dissections].

A Chavan1, M Galanski, M Pichlmaier

  • 1Abteilung Diagnostische Radiologie I, Medizinische Hochschule Hannover. Chavan.Ajay@MH-Hannover.DE

Rofo : Fortschritte Auf Dem Gebiete Der Rontgenstrahlen Und Der Nuklearmedizin
|August 30, 2000
PubMed
Summary

Interventional radiology offers a less invasive approach to treating aortic dissection complications like branch vessel ischemia, with lower mortality rates than surgery. Techniques like stent grafts can stabilize dissections by closing entry sites and promoting false lumen thrombosis.

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Area of Science:

  • Cardiovascular Medicine
  • Interventional Radiology
  • Vascular Surgery

Background:

  • Aortic dissection management traditionally involves surgery for branch vessel ischemia, carrying high mortality (25-71%).
  • Malperfusion in aortic dissection poses significant risks, including aortic rupture or aneurysm formation.

Purpose of the Study:

  • To review the percutaneous management of branch vessel ischemia in aortic dissection.
  • To discuss the role of stent graft implantation in stabilizing aortic dissections.

Main Methods:

  • Review of literature and clinical experience.
  • Discussion of interventional radiological techniques including balloon fenestration, stent implantation, and thrombolysis.
  • Evaluation of stent graft use for proximal entry site closure.

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Main Results:

  • Interventional radiology techniques provide less invasive relief of branch vessel ischemia.
  • These techniques are associated with significantly lower mortality rates (0-25%) compared to surgery.
  • Stent grafts show promise in closing entry sites, promoting false lumen thrombosis, and stabilizing dissections.

Conclusions:

  • Percutaneous management is a viable and less morbid alternative for branch vessel ischemia in aortic dissection.
  • Stent graft implantation is an emerging strategy to stabilize aortic dissections and prevent adverse outcomes.