Follow-up Of Debakey Ⅲ Type Aortic Dissection Treated By Endovascular Graft Exclusion(Report Of55Cases)

Objective The purpose of this research is to introduce the endovascular repair experience of treating55cases of Debakey Ⅲ type aortic dissection by endovascular implantment of stent-grafts, to explore the clinical application prospect of endovascular repairment..Methods We retrospectively studied55patient s who had been treated From2006April to2012August, Imaging examination by computed tomography angiography (CTA) were done to obtain anatomical detail of dissection. Stent-grafts were implanted under the guide of DSA in all cases. The patients were followed-up for3months,6months,12months, and then annually by CTA examination to observe the complications and morphological changes of the aneurysm.Results The technical success rate was89.1%(49/55),the clinical success rate was87.3%(48/55). Thromblization of false lumen was clear, no stent displacement and deformation has been found,the inside diameter of the true lumen was expanded, the inside diameter of the false lumen was narrowed (except one case), there was no significant change in the overall diameter of the descending aorta during follow-up. type Ⅰ endoleak was diagnosed in5cases, the rate of endoleak was9.1%(5/55), endoleak of a case was disappeared before discharging from hospital, another was disappeared after half a year, persistent endoleak were found in3cases, they required of close follow-up. In7cases the subclavian artery ostium was intentionally covered: two of them had the feeling of numbness and weakness at left upper limb, blood pressure was lower50～60mmHg than right upper limb, no dizziness, headache and other symptoms, review of CTA displayed distal left subclavian artery developing good.One patient died after15days from he discharged from hospital, the reason was unknown; One patient had stoke after23months. All patients had no chest pain, chest tightness and other symptoms, no paraplegia occurred. Conclusion Endovascular graft exclusion is a minimal invasive, simple, safe, effective treatment to Aortic dissection,which is encouraging with a low incidence rate of mortality and complications and with a high rate of success. It has satisfactory early and medium term results, further follow-up is necessary to evaluate its long term effectiveness.