The Evauation Of Endovascular Stent -Graft Placement For Type B Aortic Dissectiom

Background:The treatment of aortic dissection is guided by prognostic and anatomical information. Type A aortic dissection requires surgery, while the appropriate treatment of Type B aortic dissection has not been determined, neither surgical nor medical treatment is satisfying, With medical therapy alone, thrombosis of the false lumen and stabilization of the aortic tube are unpredictable, and there is also a risk of rupture or progression of the dissection.Purpose:Evaluate the safety and efficacy of endovascuar stent -graft placement for Type B aortic dissection.Methods:By retrospectivey analyzing, we reviewed 21 patients admitted to Qilu hospital from February,1995 to February,2010. Patients that underwent transluminal endovascular stent-graft placement with type B aortic dissection and compared the results with surgery in 12 controls.Results:Transluminal placement of the stent-graft prosthesis was successful in all patients, with no leakage, graft torsion or migration, guidewire-induced retrograde type A dissection or graft infection. There were no deaths or acute myocardial infraction or acute renal failure in the stent-graft group, while there were 5 deaths(41.7 percent P=0.026), 5 paraplegia or paralysis(41.7 percent P=0.026),2 acute myocardial infract ion (16.7 percent P=0.486) and 3 acute renal failure (25 percent P=0.229)in surgical group.Compared with surgical group, the stent graft group was less in the aspect of operation time(P<0.001) and hospital stay(P<0.01). Five patients of nine in the stent-graft group had postimplantation syndrome, with transient elevation of C-reactive protein levels and body temperature plus mild leukocytosis.Conclusions:1. Stent-graft treatment is a feasible and effective treatment modality in type B aortic dissection.2. Compared with surgical therapy, stent-graft treatment shortens the operation time and hospital stay, which is essential for the convalescence of paitents and the improvement of the patients living quality.3. The longer-time outcomes of stent-graft treatment is still unknown.