Treatment of chronic aortic dissection by transluminal endovascular stent-graft placement: Preliminary results

PURPOSE: To investigate efficacy of stent-graft repair for the treatment of patients with chronic aortic dissection. MATERIALS AND METHODS: Fifteen patients with chronic aortic dissection were treated with endovascular stent-grafts. Entry tears were located in the de scending thoracic aorta in all patients. The mean maximum diameter of the d escending thoracic aorta was 47 mm +/- 8. The mean diameter of the true lum en at the same level was 20 mm +/- 5. The mean interval between diagnosis a nd stent-graft procedure was 32 months +/- 91. Stent-grafts were fabricated from expanded polytetrafluoroethylene and Z-stents. RESULTS: Stent-grafts were placed successfully in all patients. Two stent-g rafts were required in one patient. Entry closure and thrombosis of the fal se lumen of the descending thoracic aorta were also achieved in all patient s. No procedure-related complications were observed except for postimplanta tion syndrome, including fever and leukocytosis. The diameter of the true l umen was significantly increased (mean, 31 mm +/- 6) at the level of the de scending thoracic aorta (P < .01) and the diameter of the aorta was signifi cantly decreased (mean, 44 mm +/- 8) at the same level (P < .01). There wer e no deaths and no instances of aortic rupture during the subsequent averag e follow-up period of 24 months. Secondary stent-graft procedures were requ ired to treat the abdominal component of dissection during follow-up in one patient. CONCLUSIONS: Stent-graft repair of chronic aortic dissection is a safe and effective method and may be an alternative to surgical graft replacement in selected patients. However, further evaluation is mandatory before this me thod is widely employed.