Key result
Endovascular treatment of complicated type B aortic dissections in 5 patients resulted in no early or late mortality, with 1 patient (20%) requiring a secondary intervention.
Why the study?
Does endovascular treatment prevent mortality and major complications in patients with complicated type B aortic dissections?
Case Report (n=5)
Does endovascular treatment prevent mortality and major complications in patients with complicated type B aortic dissections?
Endovascular treatment of complicated type B aortic dissections shows promising early results with low mortality and major complication rates in a small case series.
Supports feasibility in small series but should not change practice; leaves open need for larger prospective studies.
The purpose is to describe our experience with endovascular treatment of type B aortic dissections. Five patients were treated for complications following type B dissections like, false channel aneurysm formation, rupture and arterial obstruction. They were treated in general anaesthesia using a ‘homemade’ endoprosthesis or a commercially available endoprosthesis (Excluder®) deployed during fluoroscopy. The patients have been followed at regular intervals with a median observation time of 18 months (range 12–36). One patient needed a secondary intervention due to dislodgement of the proximal stentgraft with haemorrhage into both the false and the true lumen. Otherwise there have been no early or late mortality or major complications in this series. Even if our experience with endovascular treatment of type B dissections is rather limited, the results so far are promising. Open surgery in many of these cases is complicated with high morbidity and mortality rate and the endovascular technique offers great advantages. A longer follow-up period is necessary to define the place of endovascular treatment.
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Lundbom et al. (2001) conducted a case report in Type B aortic dissections with complications (n=5). Endovascular treatment (endoprosthesis) was evaluated on Early or late mortality and major complications. Endovascular treatment of complicated type B aortic dissections in 5 patients resulted in no early or late mortality, with 1 patient (20%) requiring a secondary intervention.
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