I-Ming Chen1,2,3, Po-Lin Chen2,3, Chun-Yang Huang2,3, Shih-Hsien Weng1,2, Wei-Yuan Chen1,2, Chun-Che Shih4,5. 1. Institute of Clinical Medicine, School of Medicine, National Yang Ming University, Taipei, Taiwan. 2. Department of Medicine, School of Medicine, National Yang Ming University, Taipei, Taiwan. 3. Division of Cardiovascular Surgery, Department of Surgery, Taipei Veterans General Hospital, Number 201, Section 2, Shih-Pai Road, Taipei, 112, Taiwan. 4. Institute of Clinical Medicine, School of Medicine, National Yang Ming University, Taipei, Taiwan. ccshih@vghtpe.gov.tw. 5. Division of Cardiovascular Surgery, Department of Surgery, Taipei Veterans General Hospital, Number 201, Section 2, Shih-Pai Road, Taipei, 112, Taiwan. ccshih@vghtpe.gov.tw.
Abstract
PURPOSE: The purpose of this study was to determine factors associated with entire aortic remodeling after thoracic endovascular aortic repair (TEVAR) in patients with type B dissection. MATERIALS AND METHODS: The patients with type B (IIIb) dissections who underwent TEVAR from 2006 to 2013 with minimum of 2 years of follow-up computed tomography data were retrospectively reviewed. Based on the status of false lumen remodeling of entire aorta, patients were divided into three groups: complete regression, total thrombosis, and inadequate regression with patent abdominal false lumen. RESULTS: A total of 90 patients (72 males, 18 females; mean age 56.6 ± 16.4 years) were included and divided into the complete regression (n = 22), total thrombosis (n = 18), and inadequate regression (n = 50) groups. Multivariate logistic regression analysis indicated that dissection extension to iliac arteries, increased preoperative number of dissection tear over abdominal aorta, and decreased preoperative abdominal aorta bifurcation true lumen ratio, as compared between the inadequate and complete regression groups, were associated with a persistent false lumen (odds ratio = 33.33, 2.304, and 0.021; all, p ≤ 0.012). Comparison of 6, 12, and 24 months postoperative data revealed no significant differences at any level, suggesting that the true lumen area ratio might not change after 6 months postoperatively. CONCLUSIONS: Increased preoperative numbers of dissection tear around the abdominal visceral branches, dissection extension to the iliac arteries, and decreased preoperative true lumen area ratio of abdominal aorta are predictive of entire aortic remodeling after TEVAR in patients with type B dissection. LEVEL OF EVIDENCE: III.
PURPOSE: The purpose of this study was to determine factors associated with entire aortic remodeling after thoracic endovascular aortic repair (TEVAR) in patients with type B dissection. MATERIALS AND METHODS: The patients with type B (IIIb) dissections who underwent TEVAR from 2006 to 2013 with minimum of 2 years of follow-up computed tomography data were retrospectively reviewed. Based on the status of false lumen remodeling of entire aorta, patients were divided into three groups: complete regression, total thrombosis, and inadequate regression with patent abdominal false lumen. RESULTS: A total of 90 patients (72 males, 18 females; mean age 56.6 ± 16.4 years) were included and divided into the complete regression (n = 22), total thrombosis (n = 18), and inadequate regression (n = 50) groups. Multivariate logistic regression analysis indicated that dissection extension to iliac arteries, increased preoperative number of dissection tear over abdominal aorta, and decreased preoperative abdominal aorta bifurcation true lumen ratio, as compared between the inadequate and complete regression groups, were associated with a persistent false lumen (odds ratio = 33.33, 2.304, and 0.021; all, p ≤ 0.012). Comparison of 6, 12, and 24 months postoperative data revealed no significant differences at any level, suggesting that the true lumen area ratio might not change after 6 months postoperatively. CONCLUSIONS: Increased preoperative numbers of dissection tear around the abdominal visceral branches, dissection extension to the iliac arteries, and decreased preoperative true lumen area ratio of abdominal aorta are predictive of entire aortic remodeling after TEVAR in patients with type B dissection. LEVEL OF EVIDENCE: III.
Entities:
Keywords:
Aortic dissection; False lumen; Remodeling; Stanford type B; TEVAR
Authors: Matti Jubouri; Fatima Kayali; Priyanshu Saha; Daniyal M Ansari; Yousef Rezaei; Sven Z C P Tan; Mostafa Mousavizadeh; Saeid Hosseini; Idhrees Mohammed; Mohamad Bashir Journal: Front Cardiovasc Med Date: 2022-03-10