ISCHEMIC COMPLICATION OF AORTIC DISSECTION - ENDOVASCULAR TYPE OF TREATMENT

We have performed 54 thoracic stentgraft placement during last 8 years. 29 procedures were implantation for aortic type B dissection in acute (13 patients) or chronic (16 patients) stage. Among dissection type B we had to treat acute ischemic complication in 3 patients and chronic stable ischemia of lower legs was treated in 3 cases. We also treated 4 patients with type A dissection one with acute occlusion of right common carotid artery and left subclavian artery, 2 with compression of true lumen above aortic bifurcation with signs of acute leg ischemia(proximal intermittent claudication) and one patient with signs of visceral mesenteric ischemia. Percutaneous angioplasty with stent implantation were the most common procedures and in 4 cases we performed aortic flap fenestration. Renal arteries were the most common treated arteries.
We usually used intravascular ultrasound for detection of true lumen collapse and navigation percutaneous procedures. We had no serious complication and all patient had angiographic and clinical improvement after procedure.