Jun Zhao1, Li-ke Shi, Xue-hua Bing. 1. Department of Vascular Surgery, No. 6 Affiliated People's Hospital, Shanghai Jiao tong University, Shanghai 200233, China. junnzhao@126.com
Abstract
OBJECTIVE: To evaluate a novel method of combining use of bare stent and coils in the treatment of aortic dissection with distal tear at celiac trunk. METHODS: From April 2007 to August 2010, two cases of Stanford type B dissections underwent initially endovascular stent-grafting to seal proximal tears while distal tears at celiac trunks failed to seal spontaneously. Bare stents were then implanted into celiac trunks crossing tears. And an appropriate amount of coils were pushed into false lumen via a catheter passing through the holes of stents for maintaining the patency of celiac trunk and sealing tears. RESULTS: Both procedures succeeded. False lumen was indistinct on angiography while celiac trunks were patent. No complication occurred. After the follow-up periods of 5 and 2 years respectively, false lumen disappeared and celiac arteries became patent. CONCLUSION: The novel method of combining use of bare stent and coils is technically simple. It required a simple puncture. Major traumas of open and hybrid operations are avoided. It is also indicated for cases of tears at renal or superior mesenteric arteries. As a supplemental method for conventional TEVAR, radical cure may be achieved for some complicated Stanford B dissections.
OBJECTIVE: To evaluate a novel method of combining use of bare stent and coils in the treatment of aortic dissection with distal tear at celiac trunk. METHODS: From April 2007 to August 2010, two cases of Stanford type B dissections underwent initially endovascular stent-grafting to seal proximal tears while distal tears at celiac trunks failed to seal spontaneously. Bare stents were then implanted into celiac trunks crossing tears. And an appropriate amount of coils were pushed into false lumen via a catheter passing through the holes of stents for maintaining the patency of celiac trunk and sealing tears. RESULTS: Both procedures succeeded. False lumen was indistinct on angiography while celiac trunks were patent. No complication occurred. After the follow-up periods of 5 and 2 years respectively, false lumen disappeared and celiac arteries became patent. CONCLUSION: The novel method of combining use of bare stent and coils is technically simple. It required a simple puncture. Major traumas of open and hybrid operations are avoided. It is also indicated for cases of tears at renal or superior mesenteric arteries. As a supplemental method for conventional TEVAR, radical cure may be achieved for some complicated Stanford B dissections.