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01.02.2009 | Vascular-Interventional

Percutaneous interventions for treating ischemic complications of aortic dissection

verfasst von: Ajay Chavan, Herbert Rosenthal, Lars Luthe, Stefanie Pfingsten, Ingo Kutschka, Jerry Easo, Siegfried Piepenbrock, Otto Dapunt, Axel Haverich, Michael Galanski

Erschienen in: European Radiology | Ausgabe 2/2009

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Abstract

The aim of this study was to evaluate the role of percutaneous interventions in treating ischemia complicating aortic dissection. Forty-five patients with ischemia complicating aortic dissection were treated by balloon fenestration, true lumen stenting, angioplasty, or thrombolysis. Clinical and laboratory examinations were performed before and after intervention, and at the end of follow-up (median 37 months). Eighteen dissections were acute, 9 sub-acute, and 18 chronic. Mesenterohepatic ischemia resolved in 16 of 18 patients; lactate and SGOT values fell from 2.89 to 1.23 mmol/L (p = 0.006) and from 165.9 to 59.7 U/L (p = 0.034), respectively. In patients with renal ischemia, creatinine levels fell from 360.1 to 196.3 μmol/L (p = 0.007) accompanied by a significant reduction in blood pressure. Limb-threatening ischemia resolved in three of four patients; in 21 claudicants, the mean walking distance improved from 272 to 1,283 m (p = 0.001). Spinal ischemia resolved completely or partially in six of eight patients. Adjunctive surgical measures were necessary in six patients. Overall 30-day mortality in the 45 patients was 6.7%; all three deaths were in patients with acute dissections (mortality in this subgroup 16.7%). Ischemia complicating aortic dissection can be effectively treated by percutaneous interventions resulting in good early and mid-term outcomes.

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Titel: Percutaneous interventions for treating ischemic complications of aortic dissection
verfasst von: Ajay Chavan
Herbert Rosenthal
Lars Luthe
Stefanie Pfingsten
Ingo Kutschka
Jerry Easo
Siegfried Piepenbrock
Otto Dapunt
Axel Haverich
Michael Galanski
Publikationsdatum: 01.02.2009
Verlag: Springer-Verlag
Erschienen in: European Radiology / Ausgabe 2/2009
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-008-1141-4

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