scholarly journals Endovascular rescue after inadvertent false lumen stent graft implantation

2016 ◽  
Vol 63 (2) ◽  
pp. 518-522 ◽  
Author(s):  
Sukgu M. Han ◽  
Warren J. Gasper ◽  
Timothy A.M. Chuter
Keyword(s):  
Stent Graft ◽  
False Lumen ◽  
Stent Graft Implantation ◽  
Graft Implantation

How to Exclude the Dilated False Lumen in Patients after a Type B Aortic Dissection? The Cork in the Bottleneck

2003 ◽  
Vol 10 (2) ◽  
pp. 244-248 ◽  
Author(s):  
Maartje C. Loubert ◽  
Victor P.M. van der Hulst ◽  
Cees De Vries ◽  
Kees Bloemendaal ◽  
Anco C. Vahl
Keyword(s):  
Aortic Dissection ◽  
Stent Graft ◽  
Case Reports ◽  
False Lumen ◽  
Type B ◽  
Type B Aortic Dissection ◽  
Type B Dissection ◽  
Occluder Device ◽  
Stent Graft Implantation ◽  
Graft Implantation

Purpose: To report techniques for excluding the dilated false lumen associated with chronic type B aortic dissection following placement of a stent-graft in the true lumen. Case Reports: Two patients underwent stent-graft implantation for a dilated false lumen after chronic aortic dissection, but the false lumen was not excluded from the circulation by this procedure. The false lumen was obliterated in one case with Greenfield filters and detachable balloons placed above a renal artery orifice that was perfused via the false lumen. This acted like “a cork in the bottleneck” to block retrograde flow into the thoracic portion of the false lumen above the blockade. In the other patient, an occluder device was used as the “cork.” In both cases, a good result was obtained. The occluder device is preferred because deployment is more controllable. Conclusions: An occluder device may be used like a cork in a bottle to exclude the dilated false lumen in the thoracic aorta after a type B dissection.

scholarly journals Hybrid endovascular repair of a dissecting thoracoabdominal aortic aneurysm with stent graft implantation through the false lumen

2014 ◽  
Vol 59 (1) ◽  
pp. 264-267 ◽  
Author(s):  
Yoshiki Watanabe ◽  
Toru Kuratani ◽  
Yukitoshi Shirakawa ◽  
Kei Torikai ◽  
Kazuo Shimamura ◽  
...  
Keyword(s):  
Aortic Aneurysm ◽  
Stent Graft ◽  
Endovascular Repair ◽  
False Lumen ◽  
Thoracoabdominal Aortic Aneurysm ◽  
Stent Graft Implantation ◽  
Graft Implantation

scholarly journals How to Guide Stent-Graft Implantation in Type B Aortic Dissection?

Circulation ◽  
2005 ◽  
Vol 112 (9_supplement) ◽  
Author(s):  
Dietmar H. Koschyk ◽  
Christoph A. Nienaber ◽  
Malgorzata Knap ◽  
Thomas Hofmann ◽  
Yskert V. Kodolitsch ◽  
...  
Keyword(s):  
Aortic Dissection ◽  
Stent Graft ◽  
Guide Wire ◽  
False Lumen ◽  
Entire Length ◽  
Type B ◽  
Type B Aortic Dissection ◽  
Complex Anatomy ◽  
Stent Graft Implantation ◽  
Graft Implantation

Background— Despite growing interest in stent-graft implantation for type-B aortic dissection, there are no established recommendations to prepare and perform an implantation procedure. Methods and Results— We directly compared angiography (ANGIO), transesophageal echocardiography (TEE), and intravascular ultrasound (IVUS) intraprocedually before and after placement of 48 stent grafts in 42 consecutive patients (12 women, 61±11 years of age) with acute and chronic type-B aortic dissection for both usefulness and capability to guide aortic stent-graft implantation. Both IVUS and TEE are superior to ANGIO to identify multiple entries (52 and 43 versus 34; P <0.005 each), to diagnose false-lumen slow flow after stent-graft implantation (32 and 31 versus 24; P <0.005 each) and to detect incomplete stent apposition (18 and 16 versus 8; P <0.005 each). In comparison with ANGIO, guide wire position over the entire length of the aorta was documented more frequently by TEE and IVUS (40 and 42 versus 25; P <0.001 each). In 4 patients with abdominal extension of the dissection, only IVUS was able to accurately identify the false lumen over the entire length of the diseased aorta. TEE was superior to IVUS and ANGIO in the detection of endoleaks (5 versus 0 and 1; P <0.05 each). Intraprocedural ANGIO, TEE, and IVUS had been performed without complications in all patients. Conclusions— TEE in conjunction with ANGIO appears to be advantageous and adds incremental information to safely guide stent-graft placement in type-B aortic dissection. Additional use of IVUS was found to be helpful in patients with complex anatomy and abdominal extension of the dissection.

Treatment of Thoracic Aortic Dissection with Stent-Grafts: Midterm Results

2002 ◽  
Vol 9 (6) ◽  
pp. 817-821 ◽  
Author(s):  
Won-Heum Shim ◽  
Bon-Kwon Koo ◽  
Young-Sup Yoon ◽  
Donghoon Choi ◽  
Yangsoo Jang ◽  
...  
Keyword(s):  
Aortic Dissection ◽  
Stent Graft ◽  
False Lumen ◽  
Endovascular Stent ◽  
Stent Grafts ◽  
Endovascular Stent Graft ◽  
Thoracic Aortic Dissection ◽  
Stent Graft Implantation ◽  
Graft Implantation

Purpose: To evaluate the early and midterm outcomes after stent-graft implantation for dissection in the descending thoracic aorta. Methods: Sixteen custom-made endovascular stent-grafts were implanted in 15 patients (10 men; mean age 55.9 ± 13.7 years, range 32–82) with descending thoracic aortic dissection. Indications for stent-graft implantation were persistent symptoms unresponsive to medical treatment or progressive enlargement of the false lumen. Clinical and imaging surveillance with computed tomography was performed within 1 month of the procedure and at 3 to 6-month intervals in follow-up. Results: Endovascular stent-graft implantation at the target site was successful in 14 (93%) patients; 1 device migrated, leaving the false lumen open to flow in the failed case. One (7%) patient who was treated emergently for rupture died suddenly 2 days after the procedure. Over an average follow-up of 31.5 ± 23.8 months, 1 (7%) patient died and 2 (14%) patients underwent surgical treatment due to recurrent dissection. The remaining 10 patients showed complete thrombosis of the false lumen; in 3, the false lumen completely resolved. Conclusions: Endovascular stent-graft implantation in descending thoracic aortic dissection is a feasible, safe, and effective treatment modality. However, further studies are necessary in a greater number of patients to determine if wider application of this minimally invasive procedure is justified.

scholarly journals Stent grafts implantation in patients with life-threatening aortic conditions – first experience in Kyrgyz Republic

2019 ◽  
Vol 3 (Issue 4) ◽  
pp. 208
Author(s):  
I.Z. Abdyldaev ◽  
S.D. Chevgun ◽  
M.A. Aripov ◽  
I.H. Bebezov ◽  
D. Ch. Cholponbaev ◽  
...  
Keyword(s):  
Stent Graft ◽  
Endovascular Aneurysm Repair ◽  
False Lumen ◽  
Kyrgyz Republic ◽  
Aortic Diseases ◽  
Stent Grafts ◽  
Life Threatening ◽  
Aortic Intima ◽  
Stent Graft Implantation ◽  
Graft Implantation

Objective: Aortic diseases remain an acute and debatable problem. Among all the aortic pathologies, the most dangerous are dynamic aneurysmal expansion, traumatic dissections and / or aneurysms, pure aortic intima dissections. Contemporary and less invasive treatment method is the stent graft implantation into aorta. This report describes the first experience of thoracic endovascular aortic repair (TEVAR) and endovascular aneurysm repair (EVAR) in the Kyrgyz Republic in consecutive patients with life-threatening aortic conditions. Methods: Nine patients, who underwent TEVAR and EVAR, were presented after all clinical examinations, echocardiography and computed tomography angiography with various life-threatening aortic diseases. Among the pathologies there were 2 (22.2%) dissections only, traumatic aneurysm 1 (11.1%), aneurysm without dissection 1 (11.1%), aneurysm with intimal dissection 5 (55.6%). Seven patients with dissection had type B (The Stanford classification). Results: TEVAR was performed in eight cases EVAR just in one. All patients reached the 6-month endpoint.  None of the following, such as aneurysm expansion, aneurysm thrombosis or a functioning of false lumen at the sites of the stent graft implantation have been recorded. In addition, no further progression of the false lumen below the implantation zones was visualized. Mean diameter of stent grafts was 31.4 ± 4.8 mm and  188.9 ± 34.6 mm in length. Conclusion: This modest observation showed the effectiveness of stent grafts implantation procedures in various aortic life-threatening conditions, such as aneurysm and / or aortic intima dissection.

Complications after Endovascular Repair of Type B Aortic Dissection

2002 ◽  
Vol 9 (6) ◽  
pp. 822-828 ◽  
Author(s):  
Reinhard S. Pamler ◽  
Thomas Kotsis ◽  
Johannes Görich ◽  
Xaver Kapfer ◽  
Karl-Heinz Orend ◽  
...  
Keyword(s):  
Aortic Dissection ◽  
Stent Graft ◽  
Subclavian Artery ◽  
Left Subclavian Artery ◽  
Type B ◽  
Type B Aortic Dissection ◽  
Stent Grafting ◽  
Stent Graft Implantation ◽  
Graft Implantation

Purpose: To outline the complications encountered after endoluminal treatment in patients with type B aortic dissection. Methods: Between 1999 and 2001, 14 patients (12 men; mean age 60.3 years, range 39–79) with isolated type B aortic dissection (13 chronic, 1 acute) underwent aortic stent-grafting. Three patients with chronic dissection presented an acute clinical picture and were managed emergently. The left subclavian artery was intentionally covered by the prosthesis in 9 patients. Follow-up studies were performed at 6-month intervals. Results: Stent-graft implantation was technically successful in all patients, but incomplete sealing (endoleak) of the entry site required additional proximal stent-graft implantation in 4. The left subclavian artery remained patent in 5 patients. Secondary conversion was required in 3 patients: 2 for acute type A dissection resulting from injury to the aortic arch by Talent endografts and a sustained hemorrhage (left hemothorax). In another patient, a secondary intramural hematoma subsided spontaneously. Anterior spinal artery syndrome in 1 patient persisted at 1 month. No bypass was necessary for the 9 patients with the covered left subclavian arteries. Mean follow-up was 14 months (range 1–23). Conclusions: Stent-grafting is feasible in patients with type B aortic dissection, although it is associated with a considerable rate of complications. Frank reporting of these sequelae for a variety of stent-grafts is of paramount importance to clarifying the limitations of the method.

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