Retrograde type A aortic dissection after endovascular stent graft placement for treatment of type B dissection
View abstract on PubMed
Summary
This summary is machine-generated.Retrograde type A aortic dissection after stent grafting for type B dissection is not rare. Stent graft factors and aortic wall fragility contribute, necessitating improved device design and techniques to reduce occurrence.
Area Of Science
- Cardiovascular Surgery
- Vascular Endovascular Therapy
Background
- Retrograde type A aortic dissection is a rare but underrecognized complication of endovascular stent grafting for type B dissection.
- This study investigates the incidence and characteristics of this life-threatening event.
Purpose Of The Study
- To determine the incidence of retrograde type A aortic dissection after endovascular stent grafting for type B dissection.
- To identify predisposing factors and outcomes associated with this complication.
Main Methods
- Retrospective review of 443 patients undergoing stent grafting for type B dissection from August 2000 to June 2007.
- Analysis of dissection location, patient comorbidities (including Marfan syndrome), and treatment outcomes.
Main Results
- Eleven patients (2.5%) developed retrograde type A aortic dissection.
- Dissection entry was primarily at the proximal bare spring of the stent graft.
- Mortality reached 27.3% among affected patients, with most requiring surgical conversion.
Conclusions
- Retrograde type A aortic dissection after type B stent grafting is not rare and results from combined aortic wall fragility and stent graft-related factors.
- Recommendations include avoiding aortic arch stent grafting in Marfan patients, using specific endograft designs, and improving endovascular techniques.