AN ASSESSMENT OF INTRACAVITY COVERED STENT TREATMENT IN 84 AORTIC DISSECTION PATIENTS

Objectives To ummarise the experiences of applying intracavity covered stent to treat Debakey III type aortic dissection, and to find out causes and solutions of various kinds of complications. Methods The 84 patients were received intracavity covered stent treatments in our hospital between January 2006 and November 2011, of which 75 patients were Debakey III type aortic dissection, and nine patient were penetrated aortic ulcer. There are 79 males and 5 females, and the average age is 52.3 years. Six of them were treated with branched stents due to the distance from aortic dissection cleavage to left subclavian artery were less than 10 mm, 20 patients were with straight stents, and the else 64 patients choosed feather-thinning stents. All patients were instructed to assess the therapy effects and observe complications by means of CTA 3 months and every year after the operation. Results The instant success rate of the operations in 84 patients is 100%. Two patients were dead in perioperative period, and one patient gained a suffering from paraplegia, in one patient the stent fell into false lumen and an internal leakage was emerging during the stent releasing process and this problem was resoluted by implanting a new stent in proximalis of the aorta, and in another one patient it was observed a symptom of subclavian blood stealing which was gradually fading away. During the follow-up visiting of 23.5±11.2 months, three patients were dead, two patients were discovered an internal aorta leakage (14.2%) and this syndrome in eight patients naturally disappeared along the time (66.7%), in one patient a new dissection appeared 2 months after the stent implantation and then a second stent was successfully placed, three patients took place aneurysmal dilatations in distal end of the aorta, the else patients had been failed to find out obvious complications such as retrograde aortic dissection, spinal cord injury, stent position shifting, and symptom of subclavian blood stealing. Conclusions The intracavity covered stent treatment is an effective method for the therapy of Debakey III type aortic dissection, at the same time the occurrences of various kinds of complications especially the sereve ones should be prevented ahead.