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Endovascular Treatment of Aortic Type B Dissection and Penetrating Ulcer Using Commercially Available Stent-Grafts

¹ Department of Angiography and Interventional Radiology, University Clinic of Radiodiagnostics, General Hospital Vienna, Währinger Gürtel 18-20, A-1090 Vienna, Austria.
² Department of Cardio-Thoracic Surgery, University Clinic of Surgery, General Hospital Vienna, A-1090 Vienna, Austria.

OBJECTIVE. The purpose of our study was to investigate the clinical experience and efficiency of translumenl endovascular stent-graft insertion using commercially available vascular endoprotheses. We studied seven patients with descending aortic dissection (type B) and four patients with penetrating aortic ulcer over a median follow-up period of 254 days during the years 1997-2000, using cross-sectional CT to evaluate the extent of the dissection, the distance between the entry tear and the left subclavian artery, and the diameter of the true lumen and the false lumen.

CONCLUSION. Endovascular treatment of acute and chronic aortic type B dissections and penetrating ulcer is a minimally invasive method with a low complication rate that could be considered a feasible alternative to surgical repair. Depending on the length of the dissection, we recommend the placement of two overlapping stent-grafts in the thoracic aorta to stabilize the affected thoracic aorta over a longer distance. This might provide a reliable sealing of the entry tear and should prevent further communication between the true lumen and the false lumen.

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