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J Thorac Cardiovasc Surg 1999;118:1021-1025
© 1999 Mosby, Inc.

SURGERY FOR ACQUIRED CARDIOVASCULAR DISEASE

AORTIC STENT GRAFTING AND SIDE-BRANCH EMBOLIZATION IN AN EXPANDING CHRONIC TYPE B DISSECTION

Bertrand Janne d’Othée, MDa, Hervé Rousseau, MDa, Philippe Soula, MDb, Bruno Dongay, MDc, Maria Ines Millan, MDa, Michel Galinier, MDc, Pierre Massabuau, MDc, Francis Joffre, MDa, Philippe Otal, MDa

From the Department of Radiology,a the Department of Cardiovascular Surgery,b and the Department of Cardiology,c Centre Hospitalier Universitaire, Hôpital de Rangueil, Toulouse, France.

Address for reprints: Professor H. Rousseau, MD, Service de Radiologie, C.H.U. Rangueil, 1, Avenue Jean Poulhès, 31403 Toulouse Cedex 4, France.

Objective: This is a report of endovascular treatment of a case of type B thoracoabdominal aortic dissection in a patient with progressive dyspnea, dorsolumbar pain, and expanding aortic diameter over a 1-year period.
Methods: Pretreatment imaging evaluation showed that the false lumen supplied only the celiac trunk. Endovascular treatment combined (1) embolization of the first segment of the celiac trunk to avoid distal back-flow into the false lumen and (2) stent grafting to occlude the initial entry tear.
Results: The treatment resulted in technical and clinical success. The patient remains asymptomatic 12 months after treatment.
Conclusion: Stent grafting offers an interesting therapeutic alternative to exclude the initial entry tear in aortic dissection and may be combined with other endovascular procedures.






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