Endovascular repair of primary retrograde Stanford type A aortic dissection
10.3760/cma.j.issn.0529-5815.2016.10.008
- VernacularTitle:腔内修复术治疗原发性逆撕型Stanford A型主动脉夹层
- Author:
Haiwei WU
1
;
Lei SUN
;
Demin LI
;
Hua JING
;
Biao XU
;
Changtian WANG
;
Lei ZHANG
Author Information
1. 210002,南京大学医学院南京军区南京总医院心胸外科
- Keywords:
Aneurysm,dissecting;
Endovascular procedures;
Treatment outcome
- From:
Chinese Journal of Surgery
2016;54(10):761-765
- CountryChina
- Language:Chinese
-
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 cndovascular 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.
