Endovascular stent-graft placement for the treatment of Stanford B type aortic dissections

ZHANG Zong-gang; DU Yu-kui; TANG He-man; LI Ming; LIU Jun; GUO Yong-zhong; Abulajiang; GUO Sheng; MA Zhong-yuan; Ayibieke; Maimaiti Aili

doi:10.3760/cma.j.issn.1673-4777.2011.08.009

Abstract：Objective To investigate clinical therapeutic effects and management in peri-and post-operation of endovascular stent-graft exclusion for Stanford B aortic dissection. Methods From December 2004 to August 2009, 40 patients with Stanford B type aortic dissection were diagnosed by contrast-enhanced CT scan. Vascular access was obtained through the right or left femoral artery after arteriotomy and stent-graft was deployed into the true lumen to occlude the primary entry tear. Immediate aortography was performed after the procedure. Blood routine, renal function, blood-serumion, four limbs blood pressure, blood oxygen saturation after the procedure were monitored. Results Totally 41 stent-grafts were installed successfully in 40 patients. Thirty-nine patients were treated successfully, while 1 case(2.5%)died. Endoleak occurred in 2 cases immediately after operation. Endoleak disappeared in one patient after stent placement and one after balloon dilation. One with acute myocardial infarction after tent-grafts installed, survived after bypass operation of coronary artery. One survived after thoracic aorta replacement due to tent-grafts shift. One emerged left lower extremity asphygmia after operation, convalesced before discharge. Three cases with acute renal failure after operation, improved from aiti-sign management. Two cases had pulmonary infection and were cured after antibiotic adjustment. None postoperation paraplegia occurred.Conclusions Endovascular stent-graft placement of the Stanford B aortic dissection possesses the advantages of micro-invasive, less severe complication and shorter hospital stay that traditional threapy. The short-term efficacy is satisfactory.