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Related Experiment Video

Updated: Dec 7, 2025

Minimally Invasive Endoscopic Intracerebral Hemorrhage Evacuation

Minimally Invasive Endoscopic Intracerebral Hemorrhage Evacuation

Published on: October 15, 2021

Stepwise external wrapping procedure for type A intramural hematoma.

Yoshihiro Suematsu¹, Takafumi Inoue¹, Satoshi Nishi¹

¹Department of Cardiovascular Surgery, Tsukuba Memorial Hospital, Tsukuba, Ibaraki, Japan.

The Journal of Thoracic and Cardiovascular Surgery

|September 26, 2020

Summary

This summary is machine-generated.

Stepwise external wrapping offers a viable surgical option for high-risk patients with Stanford type A acute intramural hematoma. This innovative technique demonstrates satisfactory early and midterm outcomes, including reduced hematoma thickness and good survival rates.

Keywords:

Stanford type A acute aortic dissection graft replacement high-risk patient intramural hematoma stepwise external wrapping

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Published on: August 11, 2015

Area of Science:

Cardiovascular Surgery
Thoracic Surgery
Vascular Surgery

Background:

Optimal treatment for Stanford type A acute intramural hematoma is debated, particularly for elderly or high-risk individuals.
Conventional treatments may pose significant risks for these patient groups.

Purpose of the Study:

To evaluate the efficacy and safety of a novel stepwise external wrapping surgical approach.
To report outcomes in high-risk patients with type A intramural hematoma treated with this technique.

Main Methods:

A stepwise external wrapping technique using artificial grafts was employed in 49 high-risk patients.
Patient cohort included those with type A intramural hematoma between January 2016 and January 2020.
Mean patient age was 78 years, with a high predicted operative risk (EuroSCORE II 54%).

Main Results:

No hospital mortality was observed.
Postoperative complications included temporary neurologic disorder (2), renal failure (1), and wound infection (2).
Significant reduction in intramural hematoma thickness was noted (18.0 mm to 5.2 mm at 3 months).
One-year and three-year survival rates were 97.7% and 89.8%, respectively, with no aortic-related deaths during follow-up.

Conclusions:

Stepwise external wrapping is a feasible alternative to conventional graft replacement for high-risk patients with type A intramural hematoma.
The procedure yielded satisfactory early and midterm outcomes.
Further long-term follow-up is warranted to fully assess the durability and safety of this approach.