Remedial surgical therapies after endovascular repair of aortic dissection
10.3760/cma.j.issn.1007-631X.2012.07.006
- VernacularTitle:胸主动脉夹层腔内修复术后的二次补救治疗分析
- Author:
Xiaohui MA
;
Wei GUO
;
Xiaoping LIU
;
Xin JIA
;
Jiang XIONG
;
Hongpeng ZHANG
;
Xin DU
;
Minhong ZHANG
- Publication Type:Journal Article
- Keywords:
Aneurgsm;
dissecting;
Vascular surgical procedures;
Endovascular therapy;
Blood vessel prosthesis
- From:
Chinese Journal of General Surgery
2012;27(7):539-542
- CountryChina
- Language:Chinese
-
Abstract:
Objective To probe into the reasons for and results of remedial surgical therapy in thoracic aortic dissection patients after first endovascalar repair.Methods From July 2000 to December 2012,12 cases received second interventional surgery.The average time from second therapy to first surgery was ( 14 ± 11 ) months.Main reasons for second endovascular therapy were sustained type Ⅰ endoleak at proximal landing zone and type A dissection caused by retrograde tear.Therapies included hybrid operations in 8 cases and absnlute endovascular therapy in 4 cases.Results The 30 day mortality after the second intervention was 5.6％ ( 1/12),total mortality rate was 16.7％ (2/12).In 7 cases with endoleak,small endoleak remained after remedial therapy (57.1％ ) in 4 cases.Among 4 cases with secondary type A aortic dissection,successful staged hybrid operation with mid-sternal thoracotomy was adopted in 3 cases,one died of pulmonary emtbolism during follow-up period,1 case with Bebcet disease still had proximal type Ⅰ endoleak after second hybrid operation,and died from tear of aorta.Conclusions Endoleak and secondary type A aortic dissection are the main cause necessitating second intervention after primary endovascular therapy for thoracic aortic dissection.Hybrid operation remains the best choice to treat postoperative complications after endovascular therapy for thoracic aortic dissection.
