Endovascular graft exclusion in treatment of thoracic aortic dissection aneurysm (Stanford B): A report of 29 cases

Objective: To introduce the techniques and effects of endovascular stent-graft exclusion in the treatment of thoracic aortic dissection aneurysm (Stanford B). Methods: Endovascular stent-graft exclusion was performed in 29 patients with thoracic aortic dissection aneurysm (Stanford B) (the range of age was from 38 to 77 years, 25 male and 4 female). Computed tomography angiography (CTA), magnetic resonance angiography (MRA) or CT was used as a preoperative evaluation methods. The position and extent of the thoracic aortic dissection aneurysm were analyzed through angiography. All of the 29 patients accepted the operations under general anesthesia. The stent-grafts were inserted from the femoral or iliac artery to exclued the aneurysm, and all operations were performed under DSA guidance. Results: Endovascular stent-graft exclusion was successfully performed in all 29 patients, Talent stent was used in 25 cases, the other 4 accepted the home-made stents. After operation, angiography of aorta showed the dissection aneurysm was excluded absolutely, or the inner leak reduced obviously. No patient had to appeal to thoracic surgery, and no perioperative death or serious complication happened. The range of postoperative follow-up was form 3 to 29 months (average 15 months). Twenty-one of the patients accepted a reexamination of CT, 8 of them were performed DSA at the same time. 3 patients accepted valve replacement about 2-8 months after operation. Conclusion: Endovascular graft exclusion is a simple, secure and effective way to treat thoracic aortic dissection aneurysm, the rate of death and complications caused by this operation is low, and a famous rate of success and survival could be acquired after the operation.