Endovascular stent-graft placement of aneurysms involving the descending aorta originating from chronic type B...

Area of Science:

• Vascular Surgery
• Interventional Cardiology
• Aortic Disease Management

Background:

• The efficacy of endovascular stent-graft repair for descending aortic aneurysms secondary to chronic type B dissections remains uncertain.
• This study addresses the performance of this technique in a complex patient cohort.

Purpose of the Study:

• To evaluate the outcomes of endovascular stent-graft placement for aneurysms in the descending aorta arising from chronic type B dissections.
• To identify critical factors for successful treatment in this challenging pathology.

Main Methods:

• Six patients with descending aortic aneurysms from chronic type B dissections were treated over two years.
• Four patients underwent supra-aortic vessel rerouting to ensure adequate proximal landing zones prior to stent-graft deployment.

Main Results:

• All patients successfully underwent supra-aortic rerouting and endovascular stent-graft placement.
• Primary entry tear closure, stent-graft expansion, and false lumen thrombosis were achieved in five patients.
• Aneurysm diameter reduction was observed in patients with successful entry tear closure; one patient had a type Ia endoleak due to a short landing zone.

Conclusions:

• Endovascular stent-graft placement is a promising treatment for descending aortic aneurysms in chronic type B dissections.
• Effective compression of the dissection membrane against the native aortic wall is feasible.
• A sufficient proximal landing zone is crucial for both immediate and long-term treatment success.