Predictors of Outcome after Endovascular Repair for Chronic Type B Dissection
2012 (English)In: European Journal of Vascular and Endovascular Surgery, ISSN 1078-5884, E-ISSN 1532-2165, Vol. 43, no 4, 386-391 p.Article in journal (Refereed) Published
Objectives: To assess the durability of endovascular repair (TEVAR) in chronic type B dissection (CD) and identify factors predictive of outcome. Design: Retrospective analysis of a prospective database.
Materials: Patients undergoing TEVAR for CD at a tertiary referral centre 2000-2010.
Methods: Analysis of pre-operative characteristics, operative outcome, false lumen thrombosis, aortic diameter and survival.
Results: 58 consecutive patients were included (49 elective, 9 urgent, mean age 66 years). Mean aortic diameter was 6.4 cm (Standard deviation SD 1.3 cm). Three patients died perioperatively (5%, 1 urgent, 2 elective). Complications included retrograde type A dissection (n = 3), paraplegia (1), and transient ischaemic attack (1). Estimated survival (Kaplan-Meier) was 89% (1-year) and 64% (3-years). Forty-seven patients had mid-term imaging follow-up at mean 38 months. Reintervention rate was 15% at 1-year and 29% at 3-years. Aortic diameter decreased in 24, was stable in 15 and increased in 8. Mid-term survival was higher in patients with aortic remodelling (reduction of aortic diameter >0.5 cm; 3-year 89%) than without (54%; Log Rank p = 0.005). Remodelling occurred with extensive false lumen thrombosis.
Conclusion: Satisfactory mid-term outcome after TEVAR for CD remains a challenge. Survival is associated with aortic remodelling, which is related to persistence of flow in the false lumen.
Place, publisher, year, edition, pages
2012. Vol. 43, no 4, 386-391 p.
Aortic dissection, Endovascular treatment, Outcome
Medical and Health Sciences
IdentifiersURN: urn:nbn:se:uu:diva-174387DOI: 10.1016/j.ejvs.2012.01.016ISI: 000302982500005OAI: oai:DiVA.org:uu-174387DiVA: diva2:527742