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01-11-2008 | Review Article

Emergency stent grafting of type B aortic dissection: technical considerations

Authors: Tommaso Lupattelli, Francesco Giuseppe Garaci, Antonio Basile, Andrea Casini, Ilias Dalainas, Daniela Paola Minnella, Roberto Iezzi

Published in: Emergency Radiology | Issue 6/2008

Abstract

Type B aortic dissection is an uncommon yet potentially catastrophic clinical event that mandates prompt recognition and expeditious treatment. Patient survival depends on early and accurate diagnosis and prompt medical or surgical treatment. Unfortunately, when type B aortic dissection is associated with end-organ ischemia, medical treatment may not prove beneficial, with patients addressed to surgery; recently, either percutaneous fenestration or primary endovascular aortic repair has been proposed as a valuable alternative to surgery in this scenario. Although the ideal endograft has not emerged and improvement in the long-term behavior of the devices is required, endograft placement is becoming the first choice in patients with complicated type B aortic dissection requiring emergency treatment.

Chen K, Varon J, Wenker OC, Judge DK, Fromm RE Jr, Sternbach GL (1997) Acute thoracic dissection: the basic. J Emerg Med 15:859–867, doi:10.1016/S0736-4679(97)00196-0 PubMedCrossRef

Wiesenfarth J (2001) Aortic dissection. Stanford University School of Medicine, Stanford, CA (monograph on line; updated)

Anangnostopoulos CE, Prabhakar MJS, Kittle CF (1972) Aortic dissection and dissecting aneurysm. Am J Cardiol 30:263–273, doi:10.1016/0002-9149(72)90070-7 CrossRef

Nienaber CA, Eagle KA (2003) Aortic dissection: new frontiers in diagnosis and management. Part I from etiology to diagnostic strategies. Circulation 108:628–635, doi:10.1161/01.CIR.0000087009.16755.E4 PubMedCrossRef

Metha RH, Suzuki T Hagan PG et al (2002) Predicting death in patients with acute type A aortic dissection. Circulation 105:200–206, doi:10.1161/hc0202.102246 CrossRef

DeBakey ME, Henly WS, Coley DA et al (1965) Surgical management of dissecting aneurysm of the aorta. J Thorac Cardiovasc Surg 49:130–149PubMed

Daily PO, Trueblood HW, Stinson EB et al (1970) Management of acute aortic dissection. Ann Thorac Surg 10:237–247PubMed

Kazui T, Tamiya Y, Tanaka T, Komatsu S (1996) Extended aortic replacement for acute type A dissection with the tear in the descending aorta. J Thorac Cardiovasc Surg 112:973–978, doi:10.1016/S0022-5223(96)70097-1 PubMedCrossRef

Metha RH, O’gara PT, Bossone E et al (2002) Acute type A aortic dissection in the elderly: clinical characteristics, management, and outcomes in the current era. J Am Coll Cardiol 40:685–692, doi:10.1016/S0735-1097(02)02005-3 CrossRef

10.

Erbel R, Oelert H, Meyer J et al (1998) Effect of medical and surgical therapy on aortic dissection evaluated by transesophageal echocardiography: implications for prognosis and therapy. Circulation 87:1604–1615

11.

Nienaber CA, Eagle KA (2003) Aortic dissection: new frontiers in diagnosis and management. Part II: therapeutic management and follow up. Circulation 108:772–778, doi:10.1161/01.CIR.0000087400.48663.19 PubMedCrossRef

12.

Suzuky T, Metha RH, Ince H et al (2003) Clinical profiles and outcomes of acute type B dissection in the current area: lesson learned from the International Registry of Aortic Dissection (IRAD). Circulation 108(Suppl II):II–12–II-317

13.

Hagan PG, Nienaber CA, Isselbacher EM (2000) The international registry of Acute Aortic Dissection (IRAD): new insights into an old disease. JAMA 283:897–903, doi:10.1001/jama.283.7.897 PubMedCrossRef

14.

Clouse WD, Hallet JW, Schaff HV, Gayary MM, Ilstrup DM, Melton LJ (1998) Improved prognosis of thoracic aortic aneurysms. JAMA 280:1926–1929, doi:10.1001/jama.280.22.1926 PubMedCrossRef

15.

Dake MD, Kato N, Mitchell RS, Semba CP, Razavi MK, Shimono T et al (1999) Endovascular stent-graft placement for the treatment of acute aortic dissection. N Engl J Med 340:1546–1552, doi:10.1056/NEJM199905203402004 PubMedCrossRef

16.

Shimono T, Kato N, Yasuda F, Suzuki T, Yuasa U et al (2002) Transluminal stent-graft placement for the treatments of acute onset and chronic aortic dissections. Circulation 106(Suppl):I-241–I-247

17.

Iezzi R, Cotroneo AR, Filippone A, Storto ML (2008) Endovascular treatment of thoracic aortic diseases: follow-up and complications with multi-detector computed tomography angiography. Eur J Radiol 65:365–376, doi:10.1016/j.ejrad.2007.09.022 PubMedCrossRef

18.

Kato M, Bai H, Sato K, Kawamoto S, Kaneko M, Ueda T et al (1995) Determining surgical indications for acute type B dissection based on enlargement of aortic diameter during the chronic phase. Circulation 92(Suppl 9):II107–II112PubMed

19.

Juvonen T, Ergin MA, Galla JD, Lansman SL, McCullough JN (1999) Risk factors for rupture of chronic type B dissections. J Thorac Cardiovasc Surg 117:776–786, doi:10.1016/S0022-5223(99)70299-0 PubMedCrossRef

20.

Elefteriades JA, Lovoulos CJ, Coady MA, Tellides G, Kopf GS, Rizzo JA (1999) Management of descending aortic dissection. Ann Thorac Surg 67:2002–2005, doi:10.1016/S0003-4975(99)00428-2 PubMedCrossRef

21.

Dake M, Miller D et al (1998) The first generation of endovascular stent-grafts for patients with aneurysms of the descending aorta. J Cardiovasc Surg (Torino) 116:689–704, doi:10.1016/S0022-5223(98)00455-3 CrossRef

22.

Hausegger K, Oberwalder P et al (2001) Intentional left subclavian artery occlusion by the thoracic aortic stent-grafts without surgical transposition. J Endovasc Ther 8:472–476, doi:10.1583/1545-1550(2001)008<0472:ILSAOB>2.0.CO;2 PubMedCrossRef

23.

Gorich J, Asquan Y, Seifarth H et al (2002) Initial experience with intentional stent graft coverage of the subclavian artery during endovascular thoracic aortic aneurysm repairs. J Endovasc Ther 9:II39–II43PubMed

24.

Parmley L, Mattingley T et al (1958) Non penetrating traumatic injury of the aorta. Circulation 17:1086–1100PubMed

25.

Kahn RA, Marin ML, Hollier L, Parsons R, Griepp R (1998) Induction of ventricular fibrillation to facilitate endovascular stent graft repair of thoracic aortic aneurysms. Anesthesiology 88:534–830, doi:10.1097/00000542-199802000-00036 PubMedCrossRef

26.

Doss M, Balzer J, Martens S, Wood JP, Wimmer-Greinecker G, Moritz A, Fieguth HG (2003) Emergent endovascular stent grafting for perforated acute type B dissections and ruptured thoracic aortic aneurysms. Ann Thorac Surg 76:493–498, doi:10.1016/S0003-4975(03)00515-0 PubMedCrossRef

27.

Duebener LF, Lorenzen P, Richardt G, Misfeld M, Nötzold A, Hartmann F et al (2004) Emergency endovascular stent-grafting for life-threatening acute type B aortic dissections. Ann Thorac Surg 78:1261–1266, doi:10.1016/j.athoracsur.2004.03.107 PubMedCrossRef

28.

Iyer V, MacKenzie K, Tse L, Abraham C, Corriveau M, Obrand D et al (2006) Early outcomes after elective and emergent endovascular repair of the thoracic aorta. J Vasc Surg 43:677–668, doi:10.1016/j.jvs.2005.12.001 PubMedCrossRef

29.

Nienaber CA, Ince H, Weber F, Rehders T, Petzsch M, Meinertz T et al (2003) Emergency stent-graft placement in thoracic aortic dissection and evolving rupture. J Card Surg 18:464–470, doi:10.1046/j.1540-8191.2003.02082.x PubMedCrossRef

30.

Bortone AS, Schena S, D’Agostino D, Dialetto G, Paradiso V et al (2002) Immediate versus delayed endovascular treatment of post-traumatic aortic pseudoaneurysms and type B dissections: retrospective analysis and premises to the upcoming European trial. Circulation 106(12 Suppl 1):I234–I240PubMed

31.

Hansen JC, Bui H, Donayre CE, Aziz I, Kim B et al (2004) Complications of endovascular repair of high-risk and emergent descending thoracic aortic aneurysms and dissections. J Vasc Surg 40:228–234, doi:10.1016/j.jvs.2004.03.051 PubMedCrossRef

32.

Kaya A, Heijmen RH, Overtoom TT, Vos JA, Morshuis WJ, Schepens MA (2006) Thoracic stent grafting for acute aortic pathology. Ann Thorac Surg 82:560–565, doi:10.1016/j.athoracsur.2006.03.053 PubMedCrossRef

33.

Dias NV, Sonesson B, Koul B, Malina M, Ivancev K (2006) Complicated acute type B dissections—an 8-years experience of endovascular stent-graft repair in a single centre. Eur J Vasc Endovasc Surg 31:481–486, doi:10.1016/j.ejvs.2005.11.005 PubMedCrossRef

34.

Pitton MB, Herber S, Schmiedt W, Neufang A, Dorweiler B, Düber C (2008) Long-term follow-up after endovascular treatment of acute aortic emergencies. Cardiovasc Intervent Radiol 31:23–35, doi:10.1007/s00270–007–9175–6 PubMedCrossRef

Title: Emergency stent grafting of type B aortic dissection: technical considerations
Authors: Tommaso Lupattelli
Francesco Giuseppe Garaci
Antonio Basile
Andrea Casini
Ilias Dalainas
Daniela Paola Minnella
Roberto Iezzi
Publication date: 01-11-2008
Publisher: Springer-Verlag
Published in: Emergency Radiology / Issue 6/2008
Print ISSN: 1070-3004
Electronic ISSN: 1438-1435
DOI: https://doi.org/10.1007/s10140-008-0759-5

At a glance: The STEP trials

Springer Medicine

Emergency stent grafting of type B aortic dissection: technical considerations

Abstract

At a glance: The STEP trials

Springer Medicine

Abstract

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