The future of stenting in patients with type A aortic dissection: a systematic review. Issue 1 (January 2020)

• Record Type: Journal Article
• Authors: Harky, Amer; Chan, Jeremy; MacCarthy-Ofosu, Beverly
• Is Part Of: Journal of international medical research. Volume 48:Issue 1(2020)
• Publication Date: 2020-01
• Subjects: Type A aortic dissection -- stenting -- open repair -- endovascular repair -- risk stratification -- survival; Medicine -- Periodicals; Pharmacology -- Periodicals; 610.5
• DOI: 10.1177/0300060519871372
• Languages: English
• ISSNs: 0300-0605

Abstract

Acute type A aortic dissection (ATAAD) carries high morbidity and mortality rates and is a clinical emergency. The reported mortality rate is 50% to 65% within the first 48 hours without surgical intervention. Open surgery therefore remains the gold standard management for ATAAD. However, in patients who are deemed unfit for surgery and where possible, endovascular repair offers a useful alternative to medical treatment alone or high-risk open surgical repair. Several case reports, case series, and retrospective studies have reported good outcomes following endovascular treatment. The endovascular option also has comparable early and late outcomes, favourable aortic remodelling, and satisfactory overall survival despite having a higher-risk patient cohort. However, stenting in patients with ATAAD undoubtedly still has several limitations and technical challenges.