Ludovic Canaud1, Thomas Gandet2, Julien Sfeir2, Baris Ata Ozdemir2, Laurence Solovei2, Pierre Alric3. 1. Department of Thoracic and Cardiovascular Surgery, Hôpital A de Villeneuve, Montpellier, France. Electronic address: ludoviccanaud@hotmail.com. 2. Department of Thoracic and Cardiovascular Surgery, Hôpital A de Villeneuve, Montpellier, France. 3. Department of Thoracic and Cardiovascular Surgery, Hôpital A de Villeneuve, Montpellier, France; CHU Montpellier, PhyMedExp, Université de Montpellier, INSERM, CNRS, Montpellier, France.
Abstract
OBJECTIVE: A review of the literature was conducted for incidence, outcomes, and risk factors for distal stent graft-induced new entry (SINE) after thoracic endovascular aortic repair (TEVAR) of aortic dissection. METHODS: The review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. RESULTS: Seven articles reporting on 1415 patients with thoracic aortic dissection undergoing TEVAR without supplemental distal bare stenting were included. In this cohort, 86 patients were treated for a residual type A aortic dissection and 1329 for a complicated type B aortic dissection. Distal SINE occurred in 112 patients (7.9%). The mean time to identification of distal SINE was 19 ± 7 months. The incidence of distal SINE after TEVAR for type B aortic dissection differed on the basis of whether it was a chronic or acute dissection repair and was, respectively, 12.9% (43/331) and 4.3% (12/273). Successful secondary interventions were performed in 54% of the patients. All the studies analyzing the relationship between distal stent graft oversizing and incidence of distal SINE reported a significantly higher rate of SINE with oversizing. CONCLUSIONS: The successful management of complicated descending thoracic aortic dissections by TEVAR is well established. Whereas distal SINE is relatively frequent, if it does occur, the complication can generally be treated with additional TEVAR without a poor outcome. The main determinant of SINE seems to be excessive distal oversizing.
OBJECTIVE: A review of the literature was conducted for incidence, outcomes, and risk factors for distal stent graft-induced new entry (SINE) after thoracic endovascular aortic repair (TEVAR) of aortic dissection. METHODS: The review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. RESULTS: Seven articles reporting on 1415 patients with thoracic aortic dissection undergoing TEVAR without supplemental distal bare stenting were included. In this cohort, 86 patients were treated for a residual type A aortic dissection and 1329 for a complicated type B aortic dissection. Distal SINE occurred in 112 patients (7.9%). The mean time to identification of distal SINE was 19 ± 7 months. The incidence of distal SINE after TEVAR for type B aortic dissection differed on the basis of whether it was a chronic or acute dissection repair and was, respectively, 12.9% (43/331) and 4.3% (12/273). Successful secondary interventions were performed in 54% of the patients. All the studies analyzing the relationship between distal stent graft oversizing and incidence of distal SINE reported a significantly higher rate of SINE with oversizing. CONCLUSIONS: The successful management of complicated descending thoracic aortic dissections by TEVAR is well established. Whereas distal SINE is relatively frequent, if it does occur, the complication can generally be treated with additional TEVAR without a poor outcome. The main determinant of SINE seems to be excessive distal oversizing.
Authors: Daniel P Sheeran; Adam M Zelickson; Luke R Wilkins; J Fritz Angle; David M Williams; Minhaj S Khaja Journal: Semin Intervent Radiol Date: 2020-03-04 Impact factor: 1.513
Authors: I Yu Zhuravleva; T P Timchenko; S V Vladimirov; M M Lyashenko; E V Kuznetsova; A M Chernyavskiy Journal: Sovrem Tekhnologii Med Date: 2021-02-28
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