Endovascular stent-graft treatment for Stanford type A aortic dissection.

OBJECTIVE

The aim of the study is to summarise our experience of endovascular stent grafting for Stanford type A aortic dissection.

DESIGN

Retrospective analysis at single centre.

METHODS

From January 2001 to January 2009, we treated 45 cases of Stanford type A aortic dissection with endovascular stent grafting. The entry tear was located at the ascending aorta in 10 cases (DeBakey type I), the aortic arch in 14 cases and the distal aortic arch or proximal descending aorta in 21 cases in which the ascending aorta was also involved by the dissection.

RESULTS

The surgical success rate was 97.8% (44/45) and 30-day mortality rate was 6.7% (3/45). Type I endoleaks occurred in 10 cases: one patient died intra-operatively, four were successfully treated with ballooning, four were sealed with aortic cuffs and one case caused by left subclavian artery (LSA) reflux was sealed with an occluder. Average follow-up time was 35.5 ± 5.4 months. Up to the most recent review or death, 32 patients had complete thrombosis and 10 had partial thrombosis inside the false lumen. Two deaths occurred after 30-days postoperatively.

CONCLUSION

Endovascular stent-graft treatment is a minimally invasive and effective method to treat Stanford type A aortic dissection.