Endovascular treatment for dissection of the descending aorta

Surgery for acute ischaemia complicating dissection of the descending aorta is associated with high mortality. We used an endovascular fenestration approach (scissor technique) to treat seven of 12 patients with ischaemic complications of descending aortic dissection; the remaining five patients were treated by stent implantation. Four of the 12 patients died (two in the fenestration group and two in the stenting group) in the days after the procedure. The remaining eight were symptom-free a mean of 9·4 (SD 8) months later. We suggest that the fenestration approach is a promising addition to endovascular treatment for patients with ischaemic complications of descending aortic dissection.