Revolutionary treatment of XXXX and dissections of descending aorta: the endovascular approach.

@entity1 @entity1066 @entity439 @entity1410 @entity2635 @entity451 @entity551 @entity1580 @entity130
BACKGROUND: Acute @entity1580 is a life-threatening medical condition. It is associated with high morbidity and mortality. Type B dissections are usually managed clinically during the acute phase. Conventional surgery carries high mortality rates due to the presence of serious complications. We herein present treatment of this condition with a less invasive endovascular approach. Other clinical situations such as penetrating @entity1066 , intramural @entity1410 , and true @entity439 of descending aorta were similarly treated. METHODS: From December 1996 to March 2002, 191 @entity1 with type B dissections were treated with self-expandable, @entity2635 -covered stents. There were 120 @entity1 (62.8%) with type B dissections, 61 @entity1 (31.9%) with true @entity439 , 6 @entity1 (3.1%) with penetrating @entity1066 or intramural @entity1410 , and 4 @entity1 (2.1%) with @entity130 . @entity1 with @entity439 (44) and stents introduced under direct vision through the aortic arch (70) were excluded. The stent graft was delivered in the catheterization laboratory under general anesthesia, with induced @entity551 and heparinization. All stents used were made in Brazil (Braile Biomedics, Sao Jose do Rio Preto, SP). RESULTS: The procedure was performed in 191 consecutive cases. The success rate was 91.1% (174/191). Success was defined as occlusion of the thoracic intimal tear, or exclusion of the @entity439 without leaks. Hospital mortality was 10.4% (20/191 @entity1 ), due to preoperative comorbidities. Six @entity1 required conversion to surgery. No case of @entity451 was observed. An actuarial survival curve showed 87.4% +/- 29% survival in the late follow-up period. CONCLUSIONS: Stent grafts are an important development in the treatment of descending aortic @entity439 or dissections. This novel approach may replace conventional surgical treatment of these conditions, with earlier intervention and less morbidity.
