Comparisons of aortic remodelling and outcomes after endovascular repair of acute and chronic complicated Type B aortic dissections
Journal
Interactive Cardiovascular and Thoracic Surgery
Journal Volume
27
Journal Issue
5
Pages
733-741
Date Issued
2018
Author(s)
Chang, Chin-Hao
Lin, Ching-Feng
Abstract
Objectives: Patients with acute (ACTBAD) or chronic complicated Type B aortic dissection (CCTBAD) undergoing thoracic endovascular aortic repair (TEVAR) remain at high risk for late aorta-related events. Few data exist on the comparison of aortic remodelling and outcomes after TEVAR between both groups.
Methods: Forty-nine patients of TEVAR for CCTBAD (n = 26) and ACTBAD (n = 23) were retrospectively reviewed at our centre.
Results: The overall 30-day mortality was 4%. Cumulative freedom from all-cause mortality (ACTBAD: 77.6%, CCTBAD: 68.8%; P = 0.76), aneurysmal-related mortality (ACTBAD: 88.2%, CCTBAD: 95.0%; P = 0.63) and the 3-year reintervention rate (ACTBAD: 92.3%, CCTBAD: 95.6%; P = 0.94) were the same in both groups. Aortic remodelling was significant (P < 0.001) above the coeliac level after TEVAR. Thirty-five (75.5%) patients still experienced false lumen flow in the abdominal aorta below the coeliac artery (ACTBAD: 16, CCTBAD: 19, P = 0.10). No difference was found in aortic remodelling between the ACTBAD and CCTBAD groups, and the length of endograft coverage had no impact on the aortic remodelling.
Conclusions: The early and 3-year follow-up in our study showed that endovascular repair for both ACTBAD and CCTBAD was safe and effective. Aortic remodelling was favourable above the coeliac artery after TEVAR, and no difference was found between ACTBAD and CCTBAD. The length of endograft coverage had no impact on aortic remodelling. The low rate of false lumen thrombosis in the abdominal aorta warranted continuous imaging surveillance.
SDGs
Other Subjects
abdominal aorta; acute complicated Type B aortic dissection; adult; aortic dissection; aortic flow; Article; cause of death; celiac artery; chronic complicated Type B aortic dissection; clinical article; clinical effectiveness; comparative study; endovascular aneurysm repair; female; human; male; mortality rate; patient safety; priority journal; reoperation; retrospective study; acute disease; blood vessel transplantation; chronic disease; computed tomographic angiography; diagnostic imaging; dissecting aneurysm; endovascular surgery; incidence; middle aged; pathophysiology; postoperative complication; procedures; stent; survival rate; Taiwan; thoracic aorta; thoracic aorta aneurysm; treatment outcome; trends; vascular remodeling; Acute Disease; Aneurysm, Dissecting; Aorta, Thoracic; Aortic Aneurysm, Thoracic; Blood Vessel Prosthesis Implantation; Chronic Disease; Computed Tomography Angiography; Endovascular Procedures; Female; Humans; Incidence; Male; Middle Aged; Postoperative Complications; Retrospective Studies; Stents; Survival Rate; Taiwan; Treatment Outcome; Vascular Remodeling
Publisher
Oxford University Press
Type
journal article