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Changing Paradigm in Endovascular Treatment of Descending Thoracic Aortic Dissections

Authors:

Joseph J. Naoum ,

Methodist DeBakey Heart & Vascular Center, The Methodist Hospital, Houston, Texas, US
About Joseph J.
M.D.
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Michael J. Reardon,

Methodist DeBakey Heart & Vascular Center, The Methodist Hospital, Houston, Texas, US
About Michael J.
M.D.
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Mark G. Davies

Methodist DeBakey Heart & Vascular Center, The Methodist Hospital, Houston, Texas, US
About Mark G.
M.D., Ph.D., M.B.A.
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Abstract

Descending thoracic dissections originating distal to the origin of the left subclavian artery carry a significant mortality if left untreated. Past thinking advocated avoiding surgical treatment of acute Stanford type B or DeBakey type III dissections, reserving therapy for chronic dissections over 14 days to a month after presentation.1 The current evolution of endovascular devices for the treatment of thoracic aneurysms has proven helpful in treating this pathology in a less invasive manner when compared to open surgical repair. The paradigm for treatment has evolved beyond the nature of the timing of the dissection: the current trend for treatment considers clinical findings and the development of complications. Complicated dissections include those that have developed aneurysmal dilatation >5.5 or 6 cm, organ or distal limb malperfusion, aortic rupture, uncontrolled hypertension even after adequate medical therapy, and persistent pain including rapid expansion of the affected aorta, among others (Table 1).2-5 This article reports on the current paradigm involving thoracic endovascular aortic repair (TEVAR) of Stanford type B or DeBakey type III dissections.

How to Cite: 1. Naoum JJ, Reardon MJ, Davies MG. Changing Paradigm in Endovascular Treatment of Descending Thoracic Aortic Dissections. Methodist DeBakey Cardiovascular Journal. 2011;7(3):25-27. DOI: http://doi.org/10.14797/mdcvj.282
Published on 01 Jul 2011.
Peer Reviewed

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