Chronic aortic dissection: Stenting of aortic true lumen obliteration withlate dynamic variations of both lumens

Three patients with chronic Stanford type B dissection presented with inter mittent claudication (n = 3), renal failure (n = 3), and hypertension that was difficult to control (n = 2). The obliterated supraceliac (n = 2) and i nfrarenal portion of the aortic true lumen (n = 1) were treated with Palmaz stents balloon-expanded to 12-20 mm. All three patients have had 14-22 mon ths of follow-up with aortography and/or CT. No periprocedural complication s occurred and all symptoms subsided. In two patients the stented aortic tr ue lumen had increased at follow-up examinations from the stented diameter of 12 mm to 20 mm and from 20 mm to 35 mm, respectively. The stents had not migrated. The increased true lumen diameter appeared to be secondary to sh rinkage of the thrombosed false lumen. In the third patient, with a patent false lumen, the stent became slightly compressed. The patients have remain ed asymptomatic. Percutaneous placement of endovascular stents may be a saf e and reliable way of relieving aortic true lumen obliteration in patients with peripheral ischemia. However, both stent compression and progressive w idening of the true lumen resulting in partial detachment of the stents may occur.