Endoluminal stent-graft management for type B aortic dissection and descending thoracic aortic aneurysm

Objective: To evaluate the feasibility and short-term early results of endoluminal stent-graft placement in the Stanford B type aortic dissection and the descending thoracic aortic aneurysms. Methods: From March 2003 to September 2005, a total of 31 patients underwent placement of endovascular stent-grafts ,including the descending thoracic aortic aneurysm (n=2) and Standford B type aortic dissection (n=29). All patients had hypertension, with urgent onset of progressive thoracic pain in 27. Two kinds of stent-graft were used in this series: the Talent (Medtronic) in 15 and Aegis (Microportmedicine, Shanghai) in 16 patients. Follow-up was carried out with clinical observations and CTA. Results: Stent-graft implantation for the proximal entry closure was successfully performed in all patients. The DSA of immediately post deployment of the stent-graft showed complete occlusion the proximal entry tear in 23/29 patients with dissection, and complete isolation of the aneurysm in two patients with aortic aneurysm. Endoleak was revealed in 6 patients with dissection. No major complications related to the procedure were encountered. Conclusions: The interventional placement of stent-graft for Type B aortic dissection and descending thoracic aortic aneurysm is safe with satisfactory short-term outcomes. Nonetheless, longer follow-up is highly desirable to assess its real advantages. (authors)