Will stent-graft repair emerge as treatment of choice for acute type B dissection?

Seminars in Vascular Surgery
Michael D Dake, David S Wang

Abstract

Endovascular stent grafts are now accepted globally and approved by the US Food and Drug Administration as an alternative to open surgical repair for patients with descending thoracic aortic aneurysm. However, as opposed to the abdominal aorta, application of this technology to manage thoracic aortic disease is not limited to degenerative aneurysms. In fact, international registries and surveys estimate that only 60% of the thoracic cases managed currently with stent-graft placement are aneurysms. The remainder of this experience includes acute dissection, chronic dissection, traumatic aortic injury, penetrating ulcer, intramural hematoma, aortic fistula, anastomotic pseudoaneurysm, and an embolizing lesion. In this regard, it is important to keep in mind that the present devices used in these nonaneurysmal applications are not designed to address the unique anatomical and pathological features that these lesions present. Consequently, in the future, it is possible that we will see stent-graft designs that focus specifically on the challenges of some of the nonaneurysmal thoracic aortic pathologies.

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Citations

Sep 16, 2014·Seminars in Vascular Surgery·Amit JainGilbert R Upchurch
May 26, 2012·Seminars in Ultrasound, CT, and MR·Anne S Chin, Dominik Fleischmann
Feb 5, 2011·Journal of Surgical Education·Pedro Puech-LeãoLuciano D Nascimento
Jul 6, 2010·The Journal of Thoracic and Cardiovascular Surgery·Jing-dong TangYu-qi Wang
Apr 13, 2010·Journal of Vascular and Interventional Radiology : JVIR·Nadine Abi-JaoudehBradford J Wood
Jan 1, 2008·Seminars in Thoracic and Cardiovascular Surgery·Dominik FleischmannD Craig Miller
Jan 23, 2009·Journal of Vascular and Interventional Radiology : JVIR·Kwang Bo ParkYeon Hyeon Choe
Oct 29, 2008·The Journal of Thoracic and Cardiovascular Surgery·Germano MelissanoRoberto Chiesa
Oct 1, 2011·Journal of Vascular Surgery·Sean O'DonnellJohn Ricotta
May 9, 2007·Journal of Endovascular Therapy : an Official Journal of the International Society of Endovascular Specialists·Germano MelissanoRoberto Chiesa

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