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Titolo:
Elective endovascular treatment of descending thoracic aortic aneurysms and chronic dissections with stent-grafts
Autore:
Won, JY; Lee, DY; Shim, WH; Chang, BC; Park, SI; Yoon, CS; Kwon, HM; Park, BH; Jung, GS;
Indirizzi:
Yonsei Univ, Coll Med, Dept Diagnost Radiol, Seodaemun Gu, Seoul 120752, South Korea Yonsei Univ Seoul South Korea 120752 aemun Gu, Seoul 120752, South Korea Yonsei Univ, Coll Med, Dept Cardiovasc Surg, Seodaemun Gu, Seoul 120752, South Korea Yonsei Univ Seoul South Korea 120752 aemun Gu, Seoul 120752, South Korea Yonsei Univ, Coll Med, Dept Cardiol, Seodaemun Gu, Seoul 120752, South Korea Yonsei Univ Seoul South Korea 120752 aemun Gu, Seoul 120752, South Korea Konyang Univ, Dept Cardiovasc Surg, Daejeon, South Korea Konyang Univ Daejeon South Korea Cardiovasc Surg, Daejeon, South Korea Donga Univ, Coll Med, Dept Diagnost Radiol, Pusan, South Korea Donga UnivPusan South Korea , Dept Diagnost Radiol, Pusan, South Korea Kosin Med Coll, Dept Radiol, Pusan, South Korea Kosin Med Coll Pusan South Korea Coll, Dept Radiol, Pusan, South Korea
Titolo Testata:
JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY
fascicolo: 5, volume: 12, anno: 2001,
pagine: 575 - 582
SICI:
1051-0443(200105)12:5<575:EETODT>2.0.ZU;2-F
Fonte:
ISI
Lingua:
ENG
Soggetto:
PLACEMENT; REPAIR; EMBOLIZATION; REPLACEMENT; MANAGEMENT;
Keywords:
aorta, aneurysm; aorta, dissection; aorta, grafts and prostheses;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
29
Recensione:
Indirizzi per estratti:
Indirizzo: Lee, DY Yonsei Univ, Coll Med, Dept Diagnost Radiol, Seodaemun Gu, 134 Shinchon Dong, Seoul 120752, South Korea Yonsei Univ 134 Shinchon Dong Seoul South Korea 120752 outh Korea
Citazione:
J.Y. Won et al., "Elective endovascular treatment of descending thoracic aortic aneurysms and chronic dissections with stent-grafts", J VAS INT R, 12(5), 2001, pp. 575-582

Abstract

PURPOSE: To report our experience of endovascular stent-graft placement inpatients with descending thoracic aortic dissections and aneurysms and to evaluate the feasibility, safety, and clinical outcomes of the treatment. MATERIALS AND METHODS: Stent-grafts were placed in the descending thoracicaortas of 23 patients with saccular aneurysms (n = 11) and Stanford type Bchronic aortic dissections of the descending thoracic and abdominal aorta (n = 12). All stent-grafts were individually constructed of self-expandablestainless steel stents covered with polytetrafluoroethylene. Vascular access was achieved through the femoral artery in all patients. Clinical statusof each patient was monitored and postoperative CT was performed within 1 month of the procedure and at 3-12-month intervals after the procedures. RESULTS: Successful exclusion of the primary entry tears of dissections and the inlets of saccular aneurysms was achieved in all but two patients with aortic dissection. The overall technical success rate was 91.3% (dissection: 10 of 12 = 83%; aneurysm: 11 of 11 = 100%). All patients in whom technical success was achieved showed complete thrombosis and significant decrease in diameter of the thoracic false lumen (preoperative: 5.3 cm +/- 0.9; postoperative: 4.3 cm +/- 0.9; P = .004) or aneurysm sac (preoperative: 5.3 cm +/- 1.7; postoperative: 2.8 cm +/- 2.5; P = .001). In addition, five patients demonstrated complete resolution of the dissected thoracic false lumen(n = 2) and aneurysm sac (n = 3). However, in all patients with aortic dissection, the abdominal aorta was not significantly changed in size (P = .302) and shape and their false lumen flows remained persistent. Immediate postoperative complications were detected in 12 patients (52%); 10 had fever, leukocytosis, and elevation of C-reactive protein, another had wound infection, and another had transient abdominal pain. Three patients died 2, 3, and 12 months after the procedure: one from septic shock, another from underlying mediastinitis, and the other from an unexplained cause. The remaining 20 patients were well after the procedure (1-9 days; mean, 3 days), withoutany stent-graft-related complications or discomfort (follow up period: 10-65 mo; mean: 25.1 mo +/- 15.6). The cumulative survival rate after the stent graft was 100% at 30 days and 91% at 12 months. CONCLUSIONS: For treatment of aortic dissection and saccular aneurysm of the descending thoracic aorta, endovascular stent-graft repair may be a technically feasible and effective treatment modality.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 04/04/20 alle ore 01:49:15