K. Tiesenhausen et al., Endovascular stent-graft repair of acute thoracic aortic dissection - Early clinical experiences, THOR CARD S, 49(1), 2001, pp. 16-20
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.