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eComment: Can we use endovascular graft stenting in all type B dissections?

Siyami Ersek Thoracic and Cardiovascular Surgery Center, Istanbul 34732, Turkey

Successful management of a combined ruptured Stanford type B aortic dissection and malperfusion syndrome with an endoluminal graft

According to the MRI angiography, this is just a thoracic descending aortic dissection with rupture [1]. Using endovascular graft stenting should be the first choice. But, if dissection spreads toward the celiac axis, SMA and renal arteries, can we use endovascular graft stenting bravely. We can say ‘NO’ if the dissection spreads from the visceral arteries, sometimes endovascular graft stenting duration is for a long time. Surgical therapy can be better than endovascular graft stenting especially for thoracic aortic rupture. Secondly, the benefit of spinal drainage is confirmed by so many studies [2]. Thirdly, why did you use CT after procedure, you can use MRI angiography again because the patient had a renal dysfunction.

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1. Kpodonu J, Ramaiah VG, Diethrich EB. Successful management of a combined ruptured Stanford type B aortic dissection and malperfusion syndrome with an endoluminal graft. Interact CardioVasc Thorac Surg 2008;7:339–341.[Abstract/Free Full Text]
2. Coselli JS, Bozinovski J, LeMaire SA. Open surgical repair of 2286 thoracoabdominal aortic aneurysms. Ann Thorac Surg 2007;83:S862–864; discussion S890–892.[Abstract/Free Full Text]

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Mehmet Ates Ibrahim Yekeler Permission Requests Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Ates, M. Articles by Yekeler, I. Search for Related Content PubMed PubMed Citation Articles by Ates, M. Articles by Yekeler, I. Related Collections Related Article