|Title:||Comparisons of aortic remodelling and outcomes after endovascular repair of acute and chronic complicated Type B aortic dissections||Authors:||Chou H.-W.
|Issue Date:||2018||Publisher:||Oxford University Press||Journal Volume:||27||Journal Issue:||5||Start page/Pages:||733-741||Source:||Interactive Cardiovascular and Thoracic Surgery||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. ? The Author(s) 2018. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.
|ISSN:||1569-9293||DOI:||10.1093/icvts/ivy167||metadata.dc.subject.other:||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
|Appears in Collections:||醫學系|
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