REVIEWS  VASCULAR SECTION 

The Journal of Cardiovascular Surgery 2006 December;47(6):651-7

Copyright © 2006 EDIZIONI MINERVA MEDICA

lingua: Inglese

Early and Medium-term results of stent-graft treatment of DeBakey Type III aortic dissection

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.