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SHR Neuro Cancer Cardio Lipid Metab Microb

Grimm, M; Loewe, C; Gottardi, R; Funovics, M; Zimpfer, D; Rodler, S; Dorfmeister, M; Schoder, M; Lammer, J; Aharinejad, S; Czerny, M.
Novel insights into the mechanisms and treatment of intramural hematoma affecting the entire thoracic aorta.
Ann Thorac Surg. 2008; 86(2):453-6 Doi: 10.1016/j.athoracsur.2008.03.078
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Co-authors Med Uni Graz
Zimpfer Daniel
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Abstract:
BACKGROUND: The purpose of this study was to address a previously not described mechanism underlying intramural hematoma (IMH) of the entire thoracic aorta and to test the hypothesis whether endovascular stent graft placement in this particular mechanism could be beneficial. METHODS: Within a 5-year period, we treated 8 patients with IMH affecting the entire thoracic aorta. The presumed site of initial plaque rupture was chosen as target for endovascular stent graft placement. RESULTS: In all patients, a small atherosclerotic plaque at the free lateral wall or at the concavity of the distal aortic arch could be identified as initial site of IMH. Endovascular stent graft placement was performed successfully in all patients. By covering the suspected primary lesion, resorption of IMH especially within the ascending aorta could be achieved. Mean follow-up is 16 months (range, 1 to 25). CONCLUSIONS: Plaque rupture may be identified as the cause of IMH in a previously unrecognized subgroup of patients. If at the convexity of the distal arch, supra-aortic branches prevent retrograde extension toward the ascending aorta. If at the free lateral wall or at the concavity, IMH may affect the entire thoracic aorta, owing to the lack of the natural barrier of the supra-aortic branches. Endovascular stent graft placement of this plaque-associated IMH may be more effective and less invasive than conventional surgery to treat the entire thoracic aortic disease.
Find related publications in this database (using NLM MeSH Indexing)
Aged - administration & dosage
Aged, 80 and over - administration & dosage
Aorta, Thoracic - diagnostic imaging
Aortic Diseases - diagnostic imaging, physiopathology, surgery
Blood Vessel Prosthesis - administration & dosage
Blood Vessel Prosthesis Implantation - administration & dosage
Female - administration & dosage
Hematoma - diagnostic imaging, physiopathology, surgery, therapy
Humans - administration & dosage
Male - administration & dosage
Middle Aged - administration & dosage
Prosthesis Design - administration & dosage
Stents - administration & dosage
Tomography, X-Ray Computed - administration & dosage

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