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[Endovascular repair of primary retrograde Stanford type A aortic dissection].
Zhonghua Wai Ke Za Zhi 2016; 54(10):761-765ZW

Abstract

Objective:

To summarize the short- and mid-term results on endovascular repair of primary retrograde Stanford type A aortic dissection with an entry tear in distal aortic arch or descending aorta.

Methods:

Between December 2009 and December 2014, 21 male patients of primary retrograde Stanford type A aortic dissection with a mean age of (52±9) years received endovascular repair in Department of Cardiothoracic Surgery, Jinling Hospital. Among the 21 cases, 17 patients were presented as ascending aortic intramural hematoma, 4 patients as active blood flow in false lumen and partial thrombosis, 8 patients as ulcer on descending aorta combined intramural hematoma in descending aorta, and 13 patients as typical dissection changes. All patients received endovascular stent-graft repair successfully, with 15 cases in acute phase and 6 cases in chronic phase.

Results:

Cone stent was implanted in 13 cases, while straight stent in 8 cases, including 1 case of left common carotid-left subclavian artery bypass surgery and 1 case of restrictive bare-metal stent implantation. No perioperative stroke, paraplegia, stent fracture or displacement, limbs or abdominal organ ischemia or other severe complications occured, except for tracheotomy in 2 patients. Active blood flow in ascending aorta or aortic arch disappeared, and intramural hematoma started being absorbed on CT angiography images before discharge. All patients were alive during follow-up (6 to 72 months), and intramural hematoma in ascending aorta and aortic arch was absorbed thoroughly. Type Ⅰ endoleak and ulcer expansion were found in 1 patient, and type Ⅳ endoleak in distal stent was found in another one patient. Secondary ascending aortic dissection was found in 1 case two years later, which was cured by hybrid procedure with cardiopulmonary bypass.

Conclusion:

Endovascular repair of primary retrograde Stanford type A aortic dissection was safe and effective, which correlated with favorable short- and mid-term results.

Authors+Show Affiliations

Department of Cardiothoracic Surgery, Jinling Hospital, Clinical Medicine School of Nanjing University, Nanjing 210002, China.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

chi

PubMed ID

27686640

Citation

Wu, H W., et al. "[Endovascular Repair of Primary Retrograde Stanford Type a Aortic Dissection]." Zhonghua Wai Ke Za Zhi [Chinese Journal of Surgery], vol. 54, no. 10, 2016, pp. 761-765.
Wu HW, Sun L, Li DM, et al. [Endovascular repair of primary retrograde Stanford type A aortic dissection]. Zhonghua Wai Ke Za Zhi. 2016;54(10):761-765.
Wu, H. W., Sun, L., Li, D. M., Jing, H., Xu, B., Wang, C. T., & Zhang, L. (2016). [Endovascular repair of primary retrograde Stanford type A aortic dissection]. Zhonghua Wai Ke Za Zhi [Chinese Journal of Surgery], 54(10), pp. 761-765. doi:10.3760/cma.j.issn.0529-5815.2016.10.008.
Wu HW, et al. [Endovascular Repair of Primary Retrograde Stanford Type a Aortic Dissection]. Zhonghua Wai Ke Za Zhi. 2016 Oct 1;54(10):761-765. PubMed PMID: 27686640.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Endovascular repair of primary retrograde Stanford type A aortic dissection]. AU - Wu,H W, AU - Sun,L, AU - Li,D M, AU - Jing,H, AU - Xu,B, AU - Wang,C T, AU - Zhang,L, PY - 2016/10/1/entrez PY - 2016/10/1/pubmed PY - 2017/7/20/medline SP - 761 EP - 765 JF - Zhonghua wai ke za zhi [Chinese journal of surgery] JO - Zhonghua Wai Ke Za Zhi VL - 54 IS - 10 N2 - Objective: To summarize the short- and mid-term results on endovascular repair of primary retrograde Stanford type A aortic dissection with an entry tear in distal aortic arch or descending aorta. Methods: Between December 2009 and December 2014, 21 male patients of primary retrograde Stanford type A aortic dissection with a mean age of (52±9) years received endovascular repair in Department of Cardiothoracic Surgery, Jinling Hospital. Among the 21 cases, 17 patients were presented as ascending aortic intramural hematoma, 4 patients as active blood flow in false lumen and partial thrombosis, 8 patients as ulcer on descending aorta combined intramural hematoma in descending aorta, and 13 patients as typical dissection changes. All patients received endovascular stent-graft repair successfully, with 15 cases in acute phase and 6 cases in chronic phase. Results: Cone stent was implanted in 13 cases, while straight stent in 8 cases, including 1 case of left common carotid-left subclavian artery bypass surgery and 1 case of restrictive bare-metal stent implantation. No perioperative stroke, paraplegia, stent fracture or displacement, limbs or abdominal organ ischemia or other severe complications occured, except for tracheotomy in 2 patients. Active blood flow in ascending aorta or aortic arch disappeared, and intramural hematoma started being absorbed on CT angiography images before discharge. All patients were alive during follow-up (6 to 72 months), and intramural hematoma in ascending aorta and aortic arch was absorbed thoroughly. Type Ⅰ endoleak and ulcer expansion were found in 1 patient, and type Ⅳ endoleak in distal stent was found in another one patient. Secondary ascending aortic dissection was found in 1 case two years later, which was cured by hybrid procedure with cardiopulmonary bypass. Conclusion: Endovascular repair of primary retrograde Stanford type A aortic dissection was safe and effective, which correlated with favorable short- and mid-term results. SN - 0529-5815 UR - https://www.unboundmedicine.com/medline/citation/27686640/[Endovascular_repair_of_primary_retrograde_Stanford_type_A_aortic_dissection]_ L2 - http://journal.yiigle.com/LinkIn.do?linkin_type=pubmed&issn=0529-5815&year=2016&vol=54&issue=10&fpage=761 DB - PRIME DP - Unbound Medicine ER -