AI Article Synopsis
- Acute type B thoracic aortic dissections have high risks of morbidity and mortality, but endoluminal methods show promise for treatment.
- A study reviewed 17 cases over 5 years, focusing on patients with complications like visceral malperfusion or pseudoaneurysms, who were treated using techniques such as endografting and percutaneous fenestration.
- The results indicated that while there were some complications, like strokes and late events, the overall success rate for reversing ischemia and sealing aneurysms was 100%, suggesting that endovascular techniques can provide effective early outcomes.
Article Abstract
Purpose: Morbidity and mortality of acute type B thoracic aortic dissections remain alarmingly high. Endoluminal options are promising.
Methods: A single-center 5-year review of 17 acute type B aortic dissections complicated by visceral malperfusion (11) or pseudoaneurysm formation (6) treated with endovascular intervention. Interventional techniques included endografting (15) and/or percutaneous fenestration (4). Median follow-up is 28 months (range 0-76 months).
Results: Median age was 55 years; 30-day death, stroke, and paraplegia rates were 0%, 17.6%, and 5.9%. Success reversing visceral ischemia or sealing a pseudoaneurysm was 100%. Cross-sectional imaging demonstrated that the false lumen was thrombosed in 9 patients, partially thrombosed in 6 patients. Late events include 1 delayed proximal type I endoleak, 1 delayed rupture of the thoracic aorta requiring successful emergent open surgical repair, and 2 unrelated late deaths.
Conclusion: Endovascular approaches to type B dissections presenting with visceral malperfusion and/or pseudoaneurysm can achieve acceptable early results.
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| http://dx.doi.org/10.1177/1538574410395039 | DOI Listing |
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