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The results of thoracic endovascular aortic repair for high-risk type B aortic dissection
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Abstract
Overview: Evaluating the efficacy of endovascular intervention in treatment of high-risk type B aortic dissection
Methods: Review a series case of high-risk type B aortic dissection cases treated with endovascular intervention at Cho Ray Hospital from January 2020 to December 2022.
Results: The study included a total of 30 patients with high-risk type B aortic dissection who underwent endovascular intervention meeting all sampling criteria. The average age was 53 years (26-73 years), with males accounting for 86.7%. The most common risk factor was hypertension (86.7%). Pain was the primary reason for hospital admission, with chest pain being the most frequent (80%). The most prevalent high-risk factors were false lumen diameter > 22mm (66.7%), followed by aortic diameter > 40mm (36.7%), and entry tear diameter > 10mm (33.3%). Regarding intervention characteristics, the average stent graft length was 207.3mm, with proximal landing zones predominantly in zone 1 (23.3%), zone 2 (40%), and zone 3 (36.7%). Twenty-nine patients were continuously monitored for an average of 4.3 months, with a complication rate of 10% including endoleak type Ia (6.9%) and retrograde dissection (3.4%). Aortic remodeling was evidenced by a significant reduction in false lumen size (p<0.001)
Conclusion: Follow-up results show a low rate of complications and a high rate of aortic reconstruction post-intervention.
Article Details
Keywords
type B aortic dissection, endovascular intervention
References
2. Isselbacher EM, Preventza O, Hamilton Black J, 3rd, et al. 2022 ACC/AHA Guideline for the Diagnosis and Management of Aortic Disease: A Report of the American Heart Association/American College of Cardiology Joint Committee on Clinical Practice Guidelines. Circulation. 2022;146(24):e334-e482.
3. Sayed A, Munir M, Bahbah EI. Aortic Dissection: A Review of the Pathophysiology, Management and Prospective Advances. Current cardiology reviews. 2021;17(4):e230421186875.
4. Xie E, Yang F, Liu Y, et al. Timing and Outcome of Endovascular Repair for Uncomplicated Type B Aortic Dissection. European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery. 2021;61(5):788-797.
5. Bossone E, Eagle KA. Epidemiology and management of aortic disease: aortic aneurysms and acute aortic syndromes. Nature reviews Cardiology. 2021;18(5):331-348.
6. Musajee M, Katsogridakis E, Kiberu Y, et al. Acute Kidney Injury in Patients with Acute Type B Aortic Dissection. European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery. 2023;65(2):256-262.
7. Fillinger MF, Greenberg RK, McKinsey JF, Chaikof EL. Reporting standards for thoracic endovascular aortic repair (TEVAR). Journal of vascular surgery. 2010;52(4):1022-1033, 1033.e1015.
8. Bavaria JE, Brinkman WT, Hughes GC, et al. Outcomes of Thoracic Endovascular Aortic Repair in Acute Type B Aortic Dissection: Results From the Valiant United States Investigational Device Exemption Study. The Annals of thoracic surgery. 2015;100(3):802-808; discussion 808-809.
9. Lombardi JV, Cambria RP, Nienaber CA, et al. Five-year results from the Study of Thoracic Aortic Type B Dissection Using Endoluminal Repair (STABLE I) study of endovascular treatment of complicated type B aortic dissection using a composite device design. Journal of vascular surgery. 2019;70(4):1072-1081.e1072.