AI Article Synopsis
- The study explores the use of a low-profile stent-graft for treating complicated aortic dissections, aiming for a less invasive percutaneous approach compared to traditional methods.
- In a trial involving 15 patients, the stent-graft was successful in excluding the entry tear in 87% of cases and achieving femoral closure in 93% with minimal complications.
- While the overall results are promising, the 30-day mortality rate was 27%, indicating the need for further research to improve outcomes in this patient population.
Article Abstract
Purpose: The use of stent-grafts has proved to be safe and effective treatment for complicated aortic dissections but usually requires surgical cutdown to accommodate large-profile devices. Preliminary results of the use of a low-profile design that allows percutaneous access are presented.
Materials And Methods: Fifteen patients with aortic dissection were treated with use of a low-profile stent-graft. Dissection types included Stanford type A (n = 6) and type B (n = 9). The procedures were performed with use of Perclose devices to achieve hemostasis. The stent-graft device was composed of Gianturco stents connected with longitudinal wire struts covered with radially expanded polytetrafluoroethylene. The delivery sheath sizes were 14-20 F.
Results: In 87% of patients (13 of 15), the entry tear was excluded completely. Successful femoral closures were achieved in 93% of patients (14 of 15) with use of the suture-mediated devices. In 7% of patients (one of 15), surgical closure of the femoral arteries was required. The rate of pseudoaneurysm occurrence was 7% (one of 15). Hospitalization ranged from 1 to 30 days with a mean duration of 6.5 days. The 30-day mortality rate was 27% (four of 15). In the remaining 11 patients, entry tear sites were excluded and, on follow-up CT examinations, there was thrombosis and retraction of the false lumen and enlargement of the true lumen.
Conclusion: Preliminary results of the use of a low-profile stent-graft device to treat aortic dissections show that, in most patients, it can be used with a suture-mediated device without surgical exposure of the common femoral artery.
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| http://dx.doi.org/10.1016/s1051-0443(07)61987-3 | DOI Listing |
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