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Indexed/Abstracted in: BIOSIS Previews, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 1,632
Online ISSN 1827-191X
Kiyotaka I., Shinichi S., Keiji U.
Department of Cardiovascular Surgery, Yokohama City University, Medical Center, Yokohama, Japan
Aim. The safety and effectiveness of transcatheter stent-graft treatment in the early and medium-term postoperative period was assessed in patients with DeBakey type III aortic dissection.
Methods. Transcatheter stent-graft implantation was performed in 37 patients who had aortic dissection with entry sites in the descending thoracic aorta. Entry sites were closed with a stent-graft consisting of a Gianturco Z stent covered with an UBE woven Dacron graft.
Results. There were no in-hospital deaths or serious complications after operation. In 5 patients, a new intimal tear developed at the distal end of the stent-graft 8 to 13 months after operation. It was closed by additional stent-graft placement in 2 patients. The rate of thrombosis of the false lumen of the descending thoracic aorta 5 to 10 days, 3 to 6 months, and 12 months after operation was 70%, 80%, and 81%, respectively. As compared with before operation, the short axis of the true lumen increased (1.4±0.8 cm before operation, 2.1±0.5 cm at 5-10 days, and 2.7±0.6 cm at 3-6 months) and that of the false lumen decreased (2.9±0.9 cm, 2.3±0.9 cm, 1.5±1.2 cm), indicating enlargement of the true lumen and shrinkage of the false lumen. The false lumen was completely obliterated within 3-6 months after operation in 6 patients.
Conclusions. Our early postoperative results show that transcatheter stent-graft implantation is a safe and effective procedure for the management of DeBakey Type III aortic dissection. Devices with a minimal risk of causing intimal tears should be developed.