Clinical efficacy of single branch stent-graft treatment for retrograde type A intramural hematoma: A retrospective cohort study
10.7507/1007-4848.202305049
- VernacularTitle:Castor单分支支架治疗逆撕型A型主动脉壁间血肿临床疗效的回顾性队列研究
- Author:
Bailang CHEN
1
;
Zanxin WANG
1
;
Xianmian ZHUANG
1
;
Haibing LIU
1
;
Yao CHEN
1
;
Rui ZHANG
1
;
Minxin WEI
1
Author Information
1. Department of Cardiovascular Surgery, The University of Hong Kong-Shenzhen Hospital, Shenzhen, 518053, Guangdong, P. R. China
- Publication Type:Journal Article
- Keywords:
Retrograde type A intramural hematoma;
single branch stent-graft;
Castor;
thoracic endovascular aortic repair
- From:
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
2025;32(08):1166-1172
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the efficacy of using a single branch stent-graft to treat primary intramural hematoma located at the distal arch or descending aorta in Stanford A type aortic intramural hematoma. Methods From July 2020 to November 2022, 10 patients with primary intramural hematoma of Stanford A type aortic intramural hematoma were treated with endovascular repair using a single branch stent-graft in the Department of Cardiovascular Surgery at The University of Hong Kong-Shenzhen Hospital. There were 9 males and 1 female, aged from 32 to 66 years, with a mean age of (47.0±10.4) years. All patients had intramural hematoma involving the ascending aorta and aortic arch, diagnosed as type A intramural hematoma, with the tear located in the descending aorta. Among them, 6 patients were complicated by ulceration of the descending aorta with intramural hematoma, and 4 patients had changes of the descending aortic dissection. All patients underwent endovascular stent repair, with 8 patients undergoing emergency surgery (≤14 days) and 2 patients undergoing subacute surgery (15 days to 3 months). Results There were no neurological complications, paraplegia, stent fracture or displacement, or limb or visceral ischemia during the perioperative period in all patients. One patient had continuous chest pain after surgery, and the stent had a new tear at the proximal end, requiring ascending aorta and partial arch replacement. As of the latest follow-up, all patients had obvious absorption or complete absorption of the intramural hematoma in the ascending aorta and aortic arch compared with before the operation. Conclusion Single branch stent-graft treatment of retrograde ascending aortic intramural hematoma is safe and effective, with good short-term results.
