Skip to Main content Skip to Navigation
Journal articles

Endovascular stent-graft management of aortic intramural hematomas.

Abstract : PURPOSE: To report initial experience with endovascular stent-grafting in aortic intramural hematoma (IMH). MATERIALS AND METHODS: From 2000 to 2006, 15 patients (mean age, 67 years; range, 54-83 y) underwent endovascular treatment of aortic IMH. Thirteen patients were admitted for acute aortic syndrome and two for traumatic aortic injury. An endovascular procedure was performed as primary treatment for four patients (type A IMH, n = 3; type B IMH, n = 1) and as a second-line therapy in 11 patients because of unfavorable evolution (type A IMH, n = 1; type B IMH, n = 10). All stent-grafts were placed in the descending aorta, even for type A IMH. The mean follow-up was 21 months (range, 6-72 months). RESULTS: The primary success rate was 93%, with complete exclusion of the lesion (n = 14). Exclusion was partial for one patient with a type I endoleak (7%). The 30-day mortality rate was zero. IMH evolution was favorable in all cases, with decreased aortic wall thickening (n = 8) or complete regression (n = 7). Complications associated with endovascular repair were mainly related to aneurysm formation (20%). The late death rate was 7%. CONCLUSIONS: Endovascular stent-graft treatment can be performed in the management of complicated IMH, even in some cases of type A IMH, when an intimal lesion is located in the isthmus or descending aorta with contraindications to surgery. This procedure offers low morbidity and mortality rates, representing a feasible therapeutic option especially for elderly patients with comorbidities. Further studies are necessary to confirm these preliminary results.
Document type :
Journal articles
Complete list of metadatas

https://www.hal.inserm.fr/inserm-00451867
Contributor : Aurélien Vesin <>
Submitted on : Monday, February 1, 2010 - 9:27:34 AM
Last modification on : Thursday, August 27, 2020 - 11:36:03 AM

Identifiers

Collections

UGA

Citation

Valérie Monnin-Bares, Frédéric Thony, Mathieu Rodiere, Vincent Bach, Rachid Hacini, et al.. Endovascular stent-graft management of aortic intramural hematomas.. Journal of vascular and interventional radiology : JVIR, 2009, 20 (6), pp.713-21. ⟨10.1016/j.jvir.2009.02.013⟩. ⟨inserm-00451867⟩

Share

Metrics

Record views

152