[Transluminal stent-graft placement for the treatment of acute aortic dissection]

We have performed transluminal stent-graft placements (TSGPs) to seal the primary entry site to treat and prevent complications of aortic dissection since 1997. Sixty patients with a primary intimal tear in descending aorta underwent TSGP. TSGP was performed in 27 acute onset dissections (AOD) with dissection-related complications instead of emergency surgery. Fourteen AOD without complications were treated to prevent aneurysmal enlargement. Nineteen chronic dissections were treated to prevent rupture. TSGP was technically successful in all cases. The hospital mortality rate was 4.9% in AOD and 0% in chronic dissections. The primary success rate was 87.8% in AOD. After hospital discharge, 2 patients died during an average follow-up of 56.2 months. Actuarial survival rate at 5 years was 90.0% in AOD. We conclude that TSGP is a reasonable treatment option for aortic dissection. However, intimal tear formations caused by the stent-graft is a problem that requires further developments of stent-grafts.