[Endovascular repair of stanford type B aortic dissections with severe complications].

OBJECTIVE

To investigate the security and efficiency of endovascular repair for Stanford type B aortic dissection (AD) with severe complications.

METHODS

Between January 2003 and December 2009, 60 patients having Stanford type B AD with severe complications were treated, including 39 males and 21 females with an average age of 43.7 years (range, 34-71 years). Severe complications included 27 cases of huge hemothorax, 1 case of paraplegia, 7 cases of acute renal failure, 10 cases of celiac trunk ischemia, 10 cases of superior mesenteric artery ischemia, and 5 cases of severe limb ischemia. Emergency stent-graft deployment were applied in all patients, and 64 stent-grafts were successfully implanted.

RESULTS

All patients survived and were followed up 3-86 months. Hemothorax disappeared after 28 days to 3 months of operation in all hemothorax patients; renal function returned normal after 1 to 9 days; limb and visceral ischemia disappeared gradually after 1 to 14 days; and muscular strength of lower limb in the paraplegia patient began to recover after 4 hours of operation. The postoperative CT angiography showed enlarged true lumen and thrombosis in the false lumen.

CONCLUSION

Emergency endovascular repair is a safe and effective method to treat Stanford type B AD with severe complications.