Abstract | OBJECTIVE: METHODS: This retrospective review included 56 patients who underwent TSI during TEVAR for Stanford B aortic dissection from Jan 2012 to May 2013 in Beijing Anzhen hospital. There were 8 patients in acute phase (within 2 weeks from onset of symptoms), 11 patients in chronic phase (greater than 2 months following initial dissection) and 37 patients in subacute phase (between 2 weeks and 2 months from onset of symptoms). Infrarenal aorta was involved in 34 patients (60.7%) and suprarenal aorta involved in 22 patients (39.3%), the mean aortic lesion length was (226 ± 13)mm. Thoracic and abdominal aortic angiography was performed during operation to measure aortic diameters of proximal and distal landing zone, and the distance between them. The proximal stent-grafts were implanted in distal aorta to the origin of left subclavian artery with oversize rate of 10%-15% according to proximal landing zone according to procedural guideline. Then the distal newly customized large tapered stent-grafts were sequentially deployed according to the diameters of both the distal end of proximal stent and distal landing zone (aortic true lumen), and overlapping length of the two stent-grafts was more than 30 mm. Patients were followed-up at 3 months, 6 months, and yearly thereafter post operation. RESULTS: TSI procedure was successful in all patients and 122 stent-grafts were implanted. The mean length of implanted stent-grafts was (197.6 ± 20.3)mm. The mean diameter taper span was (7.5 ± 1.8)mm with proximal oversize rate of (12.8 ± 3.4)% and distal oversize rate of (11.2 ± 4.1)%. The mean angle between the distal end of stent and aorta was (2.3 ± 1.3)°. The diameter of proximal and distal landing zone, and angle between the distal end of stent and aorta remained unchanged during follow up (mean: (10.0 ± 4.0) months). The total thrombosis rate of the false lumen was 98.2% (55/56), thrombosis rate of stent segment was 82.1% (46/56) . Stent-related complications were observed in 2 patients (3.6%) , including acute spinal cord ischemia due to paraplegia (n = 1) and malposition of distal stent (n = 1). CONCLUSIONS: Encouraging short-term outcomes are obtained from current personalized two stent-grafts implantation strategy for patients with Stanford B aortic dissection. Further prospective clinical studies are warranted to evaluate the long-term efficacy of this procedure.
|
Authors | Xiaoyong Huang, Lianjun Huang, Xi Guo, Yuguo Xue, Peng Li, Wenhui Wu, Guangrui Liu, Tiezheng Li, Mingliang Peng, Qinglong Zeng |
Journal | Zhonghua xin xue guan bing za zhi
(Zhonghua Xin Xue Guan Bing Za Zhi)
Vol. 43
Issue 1
Pg. 39-43
(Jan 2015)
ISSN: 0253-3758 [Print] China |
PMID | 25876721
(Publication Type: Journal Article)
|
Topics |
- Acute Disease
- Aortic Dissection
- Aorta
- Aortic Aneurysm
- Aortic Aneurysm, Thoracic
(therapy)
- Aortography
- Blood Vessel Prosthesis
- Blood Vessel Prosthesis Implantation
- Endovascular Procedures
- Humans
- Prospective Studies
- Retrospective Studies
- Stents
- Subclavian Artery
- Thrombosis
- Tomography, X-Ray Computed
- Treatment Outcome
|