Endovascular stent-graft repair of acute thoracic aortic dissection - Early clinical experiences

Background: Standard treatment of acute thoracic aortic dissection type B i s the medical therapy used for most patients, according to Stanford. Surgic al therapy involves a high mortality rate and is reserved for patients with complicated dissections. We report from four patients with acute thoracic aortic dissection, treated endoluminally by stent-graft implantation. Metho ds: Four patients with complicated acute thoracic aortic dissections type B were treated endoluminally by transfemoral stent-graft implantation. Preop erative evaluation was performed with spiral-computed tomography and calibr ated aortography. The Talent stent-graft system (Metronic) was used in all patients. Results: The primary entry tear could be sealed successfully and complete thrombosis of the false thoracic aortic lumen was obtained in all cases. In one patient, transposition of the left subclavian artery was perf ormed, in two patients the stent-grafts had to be placed across the origin of the left subclavian artery. No severe intra- or postoperative complicati ons occurred. Conclusion: Endoluminal treatment of acute thoracic aortic di ssection seems to be a less invasive and effective therapy. Long-term resul ts for this method are necessary.