Endovascular Treatment of Aortic Type B Dissection and Penetrating Ulcer Using Commercially Available Stent-Grafts
J. Sailer1,
P. Peloschek1,
T. Rand1,
M. Grabenwöger2,
S. Thurnher1 and
J. Lammer1
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.

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Fig. 1A. 71-year-old man with back pain. Angiogram of thoracic aorta
shows type B dissection before interventional therapy with flow of contrast
medium from true lumen (T) across entry tear into false lumen (F).
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Fig. 1B. 71-year-old man with back pain. Aortogram of thoracic aorta
directly after placement of two overlapping GORE Thoracic EXCLUDER
stent-grafts (W. L. Gore; Sunnyvale, CA) shows proximal and distal end of
endoprostheses (arrows) and overlapping region. Only true lumen (T)
is evident.
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Fig. 1C. 71-year-old man with back pain. Cross-sectional helical CT
scan of thoracic aorta shows type B dissection with true lumen (T) and false
lumen (F).
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Fig. 1D. 71-year-old man with back pain. Cross-sectional helical CT
scan of thoracic aorta 1 month after stent-graft placement shows enlarged true
lumen (T) and compressed and thrombosed false lumen (F).
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Fig. 1E. 71-year-old man with back pain. Cross-sectional helical CT
scan of thoracic aorta 6 months after intervention shows (E) slight
increase of false lumen (F) at level of tracheal carina and (F) heavy
increase of false lumen (F) at level of distal end of endoprosthesis. T = true
lumen.
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Fig. 1F. 71-year-old man with back pain. Cross-sectional helical CT
scan of thoracic aorta 6 months after intervention shows (E) slight
increase of false lumen (F) at level of tracheal carina and (F) heavy
increase of false lumen (F) at level of distal end of endoprosthesis. T = true
lumen.
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Fig. 1G. 71-year-old man with back pain. CT scans 7 months after
E and F show retrograde spreading of dissection, with contrast
medium in partial thrombosed false lumen (R). T = true lumen.
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Fig. 1H. 71-year-old man with back pain. CT scans 7 months after
E and F show retrograde spreading of dissection, with contrast
medium in partial thrombosed false lumen (R). T = true lumen.
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Fig. 2A. 52-year-old man with back pain. Aortogram shows penetrating
ulcer of thoracic aorta (arrow)
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Fig. 2B. 52-year-old man with back pain. Aortogram shows complete
exclusion of ulcer from arterial circulation after implantation of TALENT
stent-graft (Medtronic; Sunrise, FL). Arrows indicate proximal and distal ends
of vascular endoprosthesis.
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Copyright © 2001 by the American Roentgen Ray Society.