[Endovascular aortic repair plus chimney technique in the treatment of Stanford type B aortic dissection involving aortic arch].

OBJECTIVE

To evaluate the efficacy of endovascular aortic repair plus chimney technique in the treatment of Stanford type B aortic dissection involving aortic arch.

METHODS

From June 2009 to March 2012, 32 patients of aortic arch dissection with primary entry tear next to the orifices of supra-aortic arteries were treated with chimney technique. Chimney technique was used to reconstruct left subclavian artery (n = 2) and left common carotid artery (n = 28). Double chimney technique was use to reconstruct innominate artery and left common carotid artery simultaneously in 2 patients.

RESULTS

Four patients received emergency operation. All patients survived and were followed up for 14.3 ± 7.4 months. No type I endoleak occurred. Among 4 patients with Type II endoleak, 3 received PDA occluding implantation in left subclavian artery and 1 patient in puerperium with Marfan syndrome and pregnancy-induced hypertension syndrome recovered by conservative treatment. No severe neurological complications and left subclavian artery ischemia occurred. The locations of aortic and chimney stent-grafts were stable without any migration. All stent-grafts remained patent.

CONCLUSION

Endovascular aortic repair plus chimney technique is a safe and effective treatment for Stanford type B aortic dissection involving aortic arch.