<p><b>OBJECTIVE</b>To investigate the clinical
therapeutic effects of endovascular repair for
patients with DeBakey III
aortic dissection.</p><p><b>
METHODS</b>From December 2002 to June 2007, endovascular
TALENT stent-
graft exclusion was performed in 75 (65
males, mean age 54.4 +/- 12.6 years)
patients with DeBakey III
aortic dissection (1 young
woman due to
Ehlers-Danlos syndrome, 2 young
men due to primary
aldosteronism and
trauma respectively). All
patients were diagnosed by contrast enhanced computed
tomography (CT) or MRI.
Stent-
grafts were deployed via
femoral artery to exclude the
tear of
dissection. Aortic
angiography was performed immediately after
procedure.</p><p><b>RESULTS</b>Eighty-one
stent-
grafts were installed in 75
patients successfully without operation related
dissection. Endoleakage immediately after
stent-
graft deploying was evidenced in 25
patients and disappeared after
stent placements (n = 6) or balloon
dilation (n = 19). Two
patients died from
aortic rupture within 2 days after
procedure.
Iliac artery was torn in a
female patient with
Ehlers-Danlos syndrome, this
patient developed
hemorrhagic shock after
stent-
graft placement and recovered after anti-
shock treatments and
iliac artery replacement with synthetic
artery. During the follow-up of 1 - 24 months, 2
patients (including the
woman with
Ehlers-Danlos syndrome) suddenly died half a year after
procedure. The remaining
patients were alive and well. Repeat CT during follow up showed that reduced lumen size and
thrombosis in the false lumen. There was no
aortic rupture,
endoleak and
stent migration during the follow-up period except descending
aortic dissection distal of the
stent-
graft in 1
patient 1 year after
procedure and the
patient were successfully treated surgically without complication.</p><p><b>CONCLUSIONS</b>Endovascular repair is a safe and effective
treatment for
patients with DeBakey III
aortic dissection, suitable for old
patients with high
risk of
surgery.
Ehlers-Danlos syndrome should be considered in young DeBakey III
aortic dissection patients without
hypertension. Further studies are warranted on endovascular repair
therapy for
artery complication of
Ehlers-Danlos syndrome.</p>