Percutaneous Aortic Fenestration for Symptomatic Type B Aortic Dissection

Minimally invasive endovascular techniques have increased in popularity over the past decade, becoming the first-line therapy for managing aortic lesions requiring intervention. Several studies show improved short-term outcomes in patients receiving endovascular management over the more traditional surgical repair.[1] [2] [3] Long-term outcomes for surgical fenestrated aortic repair have been well described and this technique well tolerated in good surgical candidates.[3] Considering not all patients with acute type B aortic dissections can be managed using stent grafts due to incompatible vascular anatomy (e.g., megacava, dissection proximity to branch vessels, inadequate seal, and unsuccessful decompression of the false lumen), aortic fenestration remains an important treatment option for patients suffering from complicated acute type B aortic dissections and can be performed percutaneously.

• References

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• 3 Trimarchi S, Nienaber CA, Rampoldi V. , et al; IRAD Investigators. Role and results of surgery in acute type B aortic dissection: insights from the International Registry of Acute Aortic Dissection (IRAD). Circulation 2006; 114 (1, Suppl): I357-I364
• 4 Panneton JM, Teh SH, Cherry Jr KJ. , et al. Aortic fenestration for acute or chronic aortic dissection: an uncommon but effective procedure. J Vasc Surg 2000; 32 (04) 711-721
• 5 Pradhan S, Elefteriades JA, Sumpio BE. Utility of the aortic fenestration technique in the management of acute aortic dissections. Ann Thorac Cardiovasc Surg 2007; 13 (05) 296-300