Thorac Cardiovasc Surg 2010; 58(5): 280-284
DOI: 10.1055/s-0030-1249942
Original Cardiovascular

© Georg Thieme Verlag KG Stuttgart · New York

Complicated Acute Type B Dissections: A Single-Center Experience with Endovascular Treatment

S. Botsios1 , 2 , K. Schuermann3 , W. Maatz1 , N. Keck3 , G. Walterbusch1 , 4
  • 1Department of Thoracic- and Cardiovascular Surgery, St.‐Johannes Hospital Dortmund, Dortmund, Germany
  • 2Faculty of Medicine, University Witten/Herdecke, Witten, Germany
  • 3Department of Radiology, St.‐Johannes Hospital Dortmund, Dortmund, Germany
  • 4Institute for Heart and Circulation Research, University Witten/Herdecke, Dortmund, Germany
Further Information

Publication History

received Sep. 14, 2009

Publication Date:
02 August 2010 (online)

Abstract

Background: Complicated acute type B dissections treated surgically carry a high risk of mortality. Endovascular interventions with stent-graft prostheses are a less invasive alternative and may obviate the need for surgery in most cases. We report here on our five years' experience with endovascular stenting in complicated acute type B dissections. Patients and Methods: Between March 2001 and January 2006, 32 patients (27 males, 5 females) with a mean age of 61.4 ± 11.32 years (range 29–80) underwent stent grafting for complicated acute type B dissections. Indications were progression of dissection with impending rupture (n = 10), uncontrollable hypertension (n = 9), intractable thoracic pain (n = 7), and malperfusion syndrome (n = 6). Talent™-Medtronic (n = 34) and Excluder™-Gore (n = 3) stent-grafts were used. In 5 patients two stents were necessary. In addition to stent grafting, aortic fenestration was performed in all three cases with lower limb ischemia. Results: Endovascular stent placement was successful in all patients. Hospital mortality was 9.3 % (3/32). No deaths occurred during follow-up (mean 32 months). Conclusion: Endovascular stenting of complicated acute type B dissections represents a safe alternative to surgery. Endovascular stent-grafts of appropriate sizes should be readily available in the hospital for emergency use, thus avoiding delays in treatment.

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Dr. Spiridon Botsios

Department of Vascular Surgery
Park-Krankenhaus Leipzig

Struempellstraße 41

04289 Leipzig

Germany

Phone: + 49 34 18 64 22 53

Fax: + 49 34 18 64 22 48

Email: botsios@arcor.de