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Perioperative aortic dissection rupture after endovascular stent graft placement for treatment of type B dissection / 中华医学杂志(英文版)
Chinese Medical Journal ; (24): 1636-1641, 2013.
Article Dans Anglais | WPRIM | ID: wpr-350450
ABSTRACT
<p><b>BACKGROUND</b>The perioperative aortic dissection (AD) rupture is a severe event after endovascular stent graft placement for treatment of type B AD. However, this life-threatening complication has not undergone systematic investigation. The aim of the study is to discuss the reasons of AD rupture after the procedure.</p><p><b>METHODS</b>The medical record data of 563 Stanford type B AD patients who received thoracic endovascular repair from 2004 to December 2011 at our institution were collected and analyzed. Double entry and consistency checking were performed with Epidata software.</p><p><b>RESULTS</b>Twelve patients died during the perioperation after thoracic endovascular repair, with an incidence of 2.1%, 66.6% were caused by aortic rupture and half of the aortic rupture deaths were caused by retrograde type A AD. In our study, 74% of the non-rupture surviving patients had the free-flow bare spring proximal stent implanted, compared with 100% of the aortic rupture patients (74% vs. 100%, P = 0.213). The aortic rupture patients are more likely to have ascending aortic diameters = 4 cm (62.5% vs. 9.0%, P = 0.032), involvement the aortic arch concavity (62% vs. 27%, P = 0.041) and have had multiple stents placed (P = 0.039).</p><p><b>CONCLUSIONS</b>Thoracic AD endovascular repair is a safe and effective treatment option for AD with relative low in-hospital mortality. AD rupture may be more common in arch stent-graft patients with an ascending aortic diameter = 4 cm and with severe dissection that needs multi-stent placement. Attention should be paid to a proximal bare spring stent that has a higher probability of inducing an AD rupture. Post balloon dilation should be performed with serious caution, particularly for the migration during dilation.</p>
Sujets)
Texte intégral: Disponible Indice: WPRIM (Pacifique occidental) Sujet Principal: Rupture aortique / Chirurgie générale / Endoprothèses / Études rétrospectives / Anévrysme de l&apos;aorte thoracique / Implantation de prothèses vasculaires / Type d'étude: Étude observationnelle Limites du sujet: Adulte / Adulte très âgé / Aged80 / Femelle / Humains / Mâle langue: Anglais Texte intégral: Chinese Medical Journal Année: 2013 Type: Article

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Texte intégral: Disponible Indice: WPRIM (Pacifique occidental) Sujet Principal: Rupture aortique / Chirurgie générale / Endoprothèses / Études rétrospectives / Anévrysme de l&apos;aorte thoracique / Implantation de prothèses vasculaires / Type d'étude: Étude observationnelle Limites du sujet: Adulte / Adulte très âgé / Aged80 / Femelle / Humains / Mâle langue: Anglais Texte intégral: Chinese Medical Journal Année: 2013 Type: Article