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J Thorac Cardiovasc Surg 1999;118:773
© 1999 Mosby, Inc.

LETTERS TO THE EDITOR

Percutaneous treatment of acute aortic dissection

Tsung O. Cheng, MD

Professor of Medicine
The George Washington University
Washington, DC 20037

To the Editor:

Acute aortic dissection is frequently a surgical emergency. The recent publications of nonsurgical treatment with catheter-delivered endovascular stent-grafts by the Stanford groupGo Go 1,2 and the German-Italian groupGo 3 cast a new light on the approach to this life-threatening disease. These studies represent a milestone in the treatment of aortic dissection.

Cardiovascular catheterization and angiography are no longer for diagnosis only. They have blossomed into therapeutic applications and become an integral part of therapeutic interventions in both cardiac and vascular diseases. The Stanford experiences also represent a multi-disciplinary effort involving both cardiovascular surgeons and interventional radiologists. Stent-graft placement requires state-of-the-art image technology, as well as precise manipulation of the catheter and positioning of the stent.Go 4 The results are very promising and the future looks bright. We await more patients to receive such innovative percutaneous treatment and their long-term results.

References

  1. Slonim SM, Miller DC, Mitchell RS, Semba CP, Razavi MK, Dake MD. Percutaneous balloon fenestration and stenting for life-threatening ischemic complications in patients with acute aortic dissection. J Thorac Cardiovasc Surg 1999;117:1118-27.[Abstract/Free Full Text]
  2. Dake MD, Kato N, Mitchell RS, Semba CP, Razavi MK, Shimono T, et al. Endovascular stent-graft placement for the treatment of acute aortic dissection. N Engl J Med 1999;340:1546-52.[Medline]
  3. Nienaber CA, Fattori R, Lund G, Dieckmann C, Wolf W, von Kodolitsch Y, et al. Nonsurgical reconstruction of thoracic aortic dissection by stent-graft placement. N Engl J Med 199;340:1539-45.
  4. Vlahakes GJ. Catheter-based treatment of aortic dissection (editorial). N Engl J Med 1999;340:1585-6.




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