Midterm Results of Type B Intramural Hematoma Endovascular Treatment
| Autor: | Laura Palcau, Djelloul Gouicem, Maxime Heyndrickx, Ludovic Berger, Aurélien Felisaz, Julie Dufranc |
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| Rok vydání: | 2015 |
| Předmět: |
Male
medicine.medical_specialty Time Factors genetic structures medicine.medical_treatment Aortography Blood Vessel Prosthesis Implantation Hematoma Intramural hematoma medicine.artery Humans Medicine Thoracic aorta Endovascular treatment Aged Aged 80 and over Aortic dissection Aorta Aortic Aneurysm Thoracic business.industry Endovascular Procedures Stent General Medicine Middle Aged medicine.disease Blood Vessel Prosthesis Surgery Aortic Dissection Treatment Outcome surgical procedures operative cardiovascular system Female Stents Radiology Tomography X-Ray Computed Cardiology and Cardiovascular Medicine business Progressive disease |
| Zdroj: | Annals of Vascular Surgery. 29:898-904 |
| ISSN: | 0890-5096 |
| DOI: | 10.1016/j.avsg.2014.12.024 |
| Popis: | Recently, intramural hematoma (IMH) has been characterized as a rare variant of aortic dissection, falling within the acute aortic syndromes (AAS). Although aortic endovascular treatment seems to provide good results, no consensus has been established regarding the optimal management of IMH affecting the descending thoracic aorta (IMH B). The aim of this study was to assess long-term clinical and morphological results of IMH B treated with a stent graft.Between 2002 and 2013, 15 of the 423 (3.5%) consecutive patients with AAS were found to have IMH B. During follow-up, complications related to IMH B were observed in 10 patients, including 5 during the acute period (14 days). Surgical indications were ulcerations, refractory pain, aneurysm evolution, aortic rupture, and pleural effusion. An endovascular approach was taken for all forms with suitable anatomy.Technical success rate was 100%, with complete exclusion of lesions of the descending thoracic aorta in all cases treated with a stent graft. No neurological complications or deaths occurred within the first 30 postoperative days, nor at the end of the mean follow-up of 46 months (1-137 months). After the aortic stent graft, partial or complete regression of the hematoma was observed in all cases.IMH B is most often a progressive disease requiring long-term monitoring. In case of complications, stent-graft treatment of the descending thoracic aorta can be performed successfully in most cases. This procedure appears to be a safe technique that provides very good long-term results, with favorable remodeling of the aorta. |
| Databáze: | OpenAIRE |
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