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ludc webb

Nuno Dias

Adjunct professor

ludc webb

Endovascular treatment for chronic type B dissection: limitations of short stent-grafts revealed at midterm follow-up.


  • Brian J Manning
  • Nuno Dias
  • Thomas Ohrlander
  • Martin Malina
  • Björn Sonesson
  • Timothy Resch
  • Krassi Ivancev

Summary, in English

PURPOSE: To examine the incidence of and the indications for re-intervention, as well as the changes in aortic morphology, in patients with chronic type B aortic dissection who underwent endovascular intervention for false lumen aneurysms. METHODS: A retrospective analysis was conducted of 10 patients (8 men; mean age 63 years, range 45-79) who underwent stent-graft repair of aneurysmal false lumen expansion related to chronic type B aortic dissection at a median 16 months (range 2-71) from the initial diagnosis. All grafts had been oversized by 10% relative to the normal non-dissected aorta and were implanted to cover the primary entry tear. Follow-up computed tomography scans were analyzed to define changes in aortic morphology. RESULTS: Mean radiological follow-up was 56 months (median 64.5; range 19-86.5). There was no perioperative mortality or stroke; no cases of aortic rupture were recorded during follow-up. One patient suffered a procedure-related stroke with postoperative hemiparesis following re-intervention for proximal erosion 15 months after the initial treatment. In 6 of the 7 re-interventions performed in 6 patients at a median 42 months after the index procedure, stent-graft extension was required to treat erosion of the dissection membrane that had resulted in endoleak with false lumen reperfusion. The extent of dissection, duration of follow-up, or length of aortic coverage was not predictive of the need for re-intervention during follow-up. At last follow-up, the mean false lumen diameter at the level of the stented aorta was significantly smaller than at baseline (11+/-15 versus 24+/-15 mm, p<0.01). This was associated with false lumen thrombosis at the level of the stent-graft in 9 of 10 cases, although 7 patients had persistent false lumen perfusion distal to the stent-graft. CONCLUSION: Endovascular stent-graft treatment is effective therapy for chronic type B dissection patients with false lumen aneurysms. Erosion of the dissection membrane, causing proximal or distal endoleak, is the most common reason for re-intervention during midterm follow-up.


  • Department of Clinical Sciences, Malmö
  • Radiology Diagnostics, Malmö

Publishing year







Journal of Endovascular Therapy





Document type

Journal article


International Society of Endovascular Specialists


  • Cardiac and Cardiovascular Systems



Research group

  • Radiology Diagnostics, Malmö


  • ISSN: 1545-1550