Endovascular Repair of Acute Type B Aortic Dissection: The Early Results and Aortic Wall Changes

Her, Keun; Won, Yong Soon; Shin, Hwa Kyun; Yang, Jin Sung; Baek, Kang Seok

Abstract

BACKGROUND
This study assessed the early results of endovascular repair of acute type B aortic dissection and the aortic wall changes following endovascular repair. MATERIAL AND METHOD: From July 2008 to May 2009, the preoperative and follow-up computed tomography (CT) scans of 5 patients with acute type B aortic dissection were evaluated, and these patients had underwent stent graft implantation within 13 days of the onset of dissection (mean: 7 days; range: 3~13). The whole lumen (WL), true lumen (TL) and false lumen (FL) diameters were measured at the proximal (p), middle (m) and distal (d) third of the descending thoracic aorta. RESULT: The study included four men and one woman with an average age of 59.4+/-20.1 years (age range: 37~79 years). The follow-up CT was performed and evaluated at 7 days and 6 months. The primary tear was completely sealed in all the patients. No paraplegia, paresis or peripheral ischemia occurred and none of the patients died. No endoleaks developed in any of the patients during follow-up. The TL diameters increased from 20.4 to 33.5 mm in the proximal third (p/3), from 19.5 to 29.8 mm in the middle third (m/3) and from 15.2 to 23.5 mm in the distal third (d/3). The FL diameters decreased from 18.7 to 0 mm in the p/3, from 15.4 to 0 mm in the m/3 and from 21.4 to 8.7 mm in the d/3. The changes in the TL diameter were statistically significant in the middle and distal aorta, and those changes in the FL diameter were not statistically significant. There was a decrease in the WL after repair, but this was not statistically significant. In three patients, the false lumen disappeared completely on follow-up CT at 6 months. Two patients had patent false lumens and no thrombosis.
CONCLUSION
The early results showed that endovascular repair was effective in treating acute type B aortic dissection, and endovascular repair promoted positive aortic wall changes.