Interv Akut Kardiol. 2015;14(3):102-107

Endovascular management of acute complicated type B aortic dissection

Jan Raupach¹, Miroslav Lojík¹, Jan Vojáček², Martin Tuna², Jindřich Samek³, Vendelín Chovanec¹, Josef Bis⁴, Petr Hoffmann¹, Petr Dvořák¹, Antonín Krajina¹, Jan Harrer²

¹ Radiologická klinika, LF UK a FN Hradec Králové

² Kardiochirurgická klinika, LF UK a FN Hradec Králové

³ Klinika anesteziologie, resuscitace a intenzivní medicíny, LF UK a FN Hradec Králové

⁴ I. interní klinika LF UK a FN Hradec Králové

Aim: Retrospective analysis of results of endovascular treatment of complicated aortic dissection type B using thoracic stent grafts (SG) and stents.

Material and Methods: We treated 34 patients (7 women, 27 men, mean age 60.4 years) endovascularly due to complicated dissection

B of thoracic aorta from February 2001 to August 2014. Indication to treatment was acute rupture of aorta in 6 cases, ischemic complications

in 12 cases, early aortic expansion in 10 cases, back pain and refractory hypertension despite full medical therapy in 6 cases.

Results: We implanted 49 stent grafts in 34 patients (1.4 SG/patient). To improve perfusion of dissected aortic branches we additionally

inserted metallic stents: 4 × in pelvic arteries, 3 × in the superior mesenteric artery (SMA), 1 × in the left common carotid artery (LCCA).

Primary technical success of our treatment with placement of stent graft over the primary entry and initiation of thrombosis of false lumen

was 91.2 % (31/34). Eight patients (23.5 %) were treated in second period by additional SG implantation (3 proximal, 5 distal extensions).

In 4 patients (11.8 %) developed progressive dilatation of dissected abdominal aorta > 50mm, three patients were treated surgically

by resection of the aneurysm during follow-up period.

Conclusion: Endovascular treatment of complicated dissection of the thoracic aorta type B is in our department considered to be the

first-line therapy with promising mid-term results. Follow-up of patients after treatment using imaging methods is necessary for early

detection of possible complications and to adjust appropriate therapy.

Keywords: aortic dissection, endovascular treatment, stentgraft, spinal ischemia

Published: October 1, 2015  Show citation