Expansion Of False Lumen Research Articles

Percutaneous Management of Ischemic Complications in Patients with Type-B Aortic Dissection

To review our experience with the use of percutaneous methods to manage the ischemic complications of type-B aortic dissection. Retrospective review of our interventional radiology database identified 11 patients with acute type-B aortic dissection who underwent 13 endovascular procedures to attempt revascularization of 23 ischemic vascular territories (four mesenteric, 11 renal, eight lower extremities). Percutaneous interventions included balloon fenestration (four patients), aortic true lumen stent placement (three patients), and branch vessel stent placement (eight patients). Successful initial reperfusion of 21 of 23 vascular territories (91%) was achieved with use of percutaneous methods alone, with no 30-day mortality, in-hospital mortality, or paraplegia. One additional patient underwent successful initial treatment with use of a combined interventional/surgical approach to reperfuse an ischemic limb. One patient developed acute thrombosis of a dissected renal artery during stent placement. Increased aortic true lumen collapse later resulted in further ischemia in two patients. During follow-up (mean, 16 mo), no patient has had evidence of false lumen enlargement or late recurrent ischemia. Endovascular methods offer a less-morbid nonsurgical treatment alternative for patients with acute complicated type-B aortic dissection.

Changes of Aortic Morphology after Aortic Dissection Evaluated by CT Angiography

Background and Objectives:In aortic dissection (AD, CT angiography (CTA is useful both in initial dia- gnosis and long term follow-up. In this study, we used CTA to evaluate the morphologic changes of aorta after AD. Subjects and Methods:We reviewed the initial and follow-up CTA images of 43 patients with AD. The diagnoses were double-lumen dissection (n=13, intramural hematoma (n=11, and residual dissection after surgery (n=19. The duration of CTA follow-up was 3.3±1.9 years (range 7-89 months. After reviewing the CTA images of the thoracic aorta level, and of the upper and lower abdominal aorta levels, we compared the areas of total lumen, true lumen and false lumen and the area ratio of true/total lumen. Results:Changes in luminal areas were greatest in the thoracic aorta, where both the true lumen area and the ratio of true/total lumen area increased. Subgroup analysis revealed that although the total lumen area increased significantly in the classic AD group, no changes were noted in the ratio of true/total lumen area. Only the increase in false lu- men area (from 5.8 cm 2 to 9.0 cm 2 was significant (p=0.036. In patients with intramural hematoma, a decr- ease in total lumen area and an increase in the ratio of true/total lumen area were noted. Conclusion:In classic AD, false lumen dilatation occurs with false lumen enlargement, whereas in intramural hematoma total aorta size decreases with any increase in the ratio of true/total lumen area. ( ( ( (Korean Circulation J 2002;32(1 :53-60

Endografts for Aortic Dissection

Endografts for Aortic Dissection