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Stent-graft induced new entry tears after type B aortic dissection: how to treat and how to prevent?
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Vascular Surgery.
2018 (English)In: Journal of Cardiovascular Surgery, ISSN 0021-9509, E-ISSN 1827-191X, Vol. 59, no 6, p. 789-796Article, review/survey (Refereed) Published
Abstract [en]

Progress of aortic disease after stent-graft treatment of aortic dissection includes the risk of stent graft-induced new entry (SINE). In this paper we review the incidence and mechanisms thought to be responsible for retrograde ascending and distal SINE after thoracic endovascular aortic repair (TEVAR) for type B dissection, and examine potential techniques for treatment and prevention. Although the risk of proximal SINE is low, the fatality of this complication requires vigilance in patients who develop new onset symptoms in the early period after TEVAR treatment. Careful technique, minimal oversizing, and use of disease specific stent grafts may reduce the risk for proximal SINE. Distally, SINE is more frequently seen during follow-up in patients treated for chronic dissection. The most important risk factor is oversizing of the stent-graft compared to the true lumen distal landing zone. Development of new disease specific stent grafts with reduced distal radial force may reduce the risk for distal SINE.

Place, publisher, year, edition, pages
EDIZIONI MINERVA MEDICA , 2018. Vol. 59, no 6, p. 789-796
Keywords [en]
Aneurysm, dissecting, Stents, Endovascular procedures
National Category
Cardiac and Cardiovascular Systems Surgery
Identifiers
URN: urn:nbn:se:uu:diva-376314DOI: 10.23736/S0021-9509.18.10570-2ISI: 000456108200006PubMedID: 29781592OAI: oai:DiVA.org:uu-376314DiVA, id: diva2:1285745
Available from: 2019-02-05 Created: 2019-02-05 Last updated: 2019-02-05Bibliographically approved

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Burdess, AnneMani, KevinTegler, GustafWanhainen, Anders

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