Endovascular fenestration in aortic dissection with acute malperfusion syndrome: Immediate and late follow-up Marco Midulla, MD, Armelle Renaud, MD,

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Presentation transcript:

Endovascular fenestration in aortic dissection with acute malperfusion syndrome: Immediate and late follow-up Marco Midulla, MD, Armelle Renaud, MD, Thomas Martinelli, MD, Mohammad Koussa, MD, Claire Mounier-Vehier, MD, PhD, Alain Prat, MD, Jean-Paul Beregi, MD, PhD The Journal of Thoracic and Cardiovascular Surgery Volume 142, Issue 1, Pages 66-72 (July 2011) DOI: 10.1016/j.jtcvs.2010.07.081 Copyright © 2011 The American Association for Thoracic Surgery Terms and Conditions

Figure 1 Angiogram into true lumen before fenestration (A) showing virtual true lumen with opacification of celiac trunk and superior mesenteric artery. Abdominal aorta and renal arteries were not visualized by injection of contrast media into descending thoracic aorta. B, Fenestration technique with 2 guidewires into 1 introducer sheath starting at level of right iliac artery up to celiac trunk. C, A large balloon was then inflated into the true lumen and pulled down from the thoracic aorta to the abdominal aorta. D, After fenestration, angiography of bowel arteries and abdominal aorta was obtained. E, Acute intrarenal dissection (ARD) treated with 2 self-expandable stent inducing complete recovery of right kidney perfusion. F, Selective arteriogram performed on left renal artery (ARG) showed no need for additional treatment. The Journal of Thoracic and Cardiovascular Surgery 2011 142, 66-72DOI: (10.1016/j.jtcvs.2010.07.081) Copyright © 2011 The American Association for Thoracic Surgery Terms and Conditions

Figure 2 Computed tomography (CT) angiogram at 2 years of follow-up demonstrated good efficacy of fenestration with good patency of superior mesenteric artery (A) and good patency of proximal (B) and distal (C) stenting of right renal artery. Both kidneys were enhanced at same time. The Journal of Thoracic and Cardiovascular Surgery 2011 142, 66-72DOI: (10.1016/j.jtcvs.2010.07.081) Copyright © 2011 The American Association for Thoracic Surgery Terms and Conditions

Figure 3 Early mortality in population depending on type of dissection and moment of fenestration. The Journal of Thoracic and Cardiovascular Surgery 2011 142, 66-72DOI: (10.1016/j.jtcvs.2010.07.081) Copyright © 2011 The American Association for Thoracic Surgery Terms and Conditions