Emergent endovascular stent-graft placement to treat ruptured Stanford type B acute aortic dissection Saori Kawamura, MD, Hiroshi Nishimaki, MD, PhD,

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Presentation transcript:

Emergent endovascular stent-graft placement to treat ruptured Stanford type B acute aortic dissection Saori Kawamura, MD, Hiroshi Nishimaki, MD, PhD, Zong-Bo Lin, MD, PhD, Masato Machii, MD, PhD, Yoshinori Isobe, MD, Kazushige Hayakawa, MD, PhD, Kazui Soma, MD, PhD Journal of Vascular Surgery Volume 39, Issue 3, Pages 668-671 (March 2004) DOI: 10.1016/j.jvs.2003.08.015

Fig 1 Case 1. A and B, Contrast-enhanced computed tomography scans obtained at admission demonstrate a false lumen in the aorta, with a mediastinal hematoma (arrows). C, Thoracic aortogram obtained 12 hours after admission shows severe narrowing of the true lumen and flow of contrast medium from the true lumen into the false lumen (arrow). Journal of Vascular Surgery 2004 39, 668-671DOI: (10.1016/j.jvs.2003.08.015)

Fig 2 A, Thoracic aortogram after stent-graft placement shows marked expansion of the true lumen. B, Stent graft. Left panel shows curved framework of the stents. Length of the wire leg is 25 mm at the major curvature and 18 mm at the minor curvature. Black arrows indicate fluoroscopic markers. Right panel shows characteristic V-shaped cut in the stent graft. White arrow indicates fluoroscopic marker at the uppermost stent on the minor curvature surface. C, Follow-up computed tomography scans (case 1) show thrombus in the false lumen and decrease in size of the mediastinal hematoma after 1 week (arrows). D, Further shrinkage of the thrombus in the false lumen is noted after 2 months. Journal of Vascular Surgery 2004 39, 668-671DOI: (10.1016/j.jvs.2003.08.015)

Fig 3 Case 2. A and B, Computed tomography scans obtained at admission show false lumen in the descending aorta and extensive left-sided hemothorax with a high-density hematoma. C, Thoracic aortogram obtained at admission shows flow of contrast medium from the true lumen into the false lumen across the entry tear (arrows). D, Dilatation of the true lumen after 2 months. Journal of Vascular Surgery 2004 39, 668-671DOI: (10.1016/j.jvs.2003.08.015)