Clinical Outcomes of Percutaneous Placement of the Self-expandable Stent-graft in Traumatic Dissection of the Thoracic Aorta

Tae-seok Seo ¹, Myung Gyu Song ¹, Sung-Joon Park ¹, Yang-gi Ryu ²

¹ Department of Radiology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea (South); ² Department of Thoracic and Cardiovascular Surgery, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea (South);

Date, time and location: 2018.05.26 17:00, Congress Hall, 2F–A

Abstract

Purpose

The purpose of this study was to evaluate clinical technical and clinical outcomes of percutaneous placement of the self-expandable stent-graft in traumatic dissection of the thoracic aorta.

Method:

Self-expandable stent-grafts (Seal Stent-graft, S&G Biotech, Sungnam, Korea) were placed in 10 patients with traumatic dissection of the thoracic aorta under local anesthesia from April 2010 to December 2016. They were 9 men and 1 woman (mean age, 46.8 years, range, 24-72 years). Causes of the injury were traffic accident (in-car (n=3), motor bike (n=2), pedestrian (n=2)), fall-down (n=2), and falling object (n=1). Stent-grafts were placed percutaneously after arteriotomy of the right femoral artery.

Medical records and images were retrospectively reviewed to review techniques and evaluated patients’ outcomes. Length of the proximal landing zone from origin of the left subclavian artery was measured on chest CT scan obtained before procedure. On angiographic images, length of false lumen, location of the proximal end of the graft, endoleak, and flow of the left subclavian artery were evaluated. On follow-up CT, exclusion of dissected lumen and long-term complication were evaluated.

Result:

Stent-graft placement were successful technically in all patients. Mean length of the landing zone was 30.4mm (range: 23-40mm) on CT scan. On angiogram, mean length of the false lumen was 49.5mm (range: 40-75mm). Proximal end of the graft was located between proximal 8mm and distal 5mm of origin of the left subclavian artery, but compromising of blood flow was not developed. Endoleak and access site complication were not developed. All patients discharged alive and dissection lumens were excluded completely without endoleak on follow-up CT (range 1-2007 days).

Conclusion:

Percutaneous placement of the self-expandable stent-graft showed good technical and clinical outcomes in traumatic dissection of the thoracic aorta.