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Treatment of Stanford type B aortic dissection with stent-grafts: preliminary results
B V Czermak1, P Waldenberger, G Fraedrich
1Department of Radiology I, Leopold-Franzens Medical School and University Hospital Innsbruck, Anichstrasse 35, 6020 Innsbruck, Austria. 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.