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Outcomes of Endovascular Management for Complicated Chronic Type B Aortic Dissection: Effect of the Extent of Stent Graft Coverage and Anatomic Properties of Aortic Dissection

Title
Outcomes of Endovascular Management for Complicated Chronic Type B Aortic Dissection: Effect of the Extent of Stent Graft Coverage and Anatomic Properties of Aortic Dissection
Authors
Myungsu Lee;Do Yun Lee;Young-Guk Ko;Donghoon Choi;Sak Lee;Young Nam Yoon;Sung Il Park;Jong Yun Won;Mu Sook Lee;Man Deuk Kim
Issue Date
2013
Journal Title
Journal of Vascular and Interventional Radiology
ISSN
1051-0443
Citation
Journal of Vascular and Interventional Radiology, Vol.24(10) : 1451~1460, 2013
Abstract
PURPOSE: To assess the effect of the extent of stent graft coverage and anatomic properties of aortic dissection on the outcomes of thoracic endovascular aortic repair (TEVAR) for complicated chronic type B aortic dissection (CCBAD) in terms of survival, reintervention, and false lumen thrombosis. MATERIALS AND METHODS: A retrospective analysis was performed of 71 patients who underwent TEVAR for CCBAD. Mean patient age was 54.7 years. Distal extent of stent graft coverage was categorized as short (≤ T7) or long (≥ T8) coverage. Indications of reintervention were categorized into three groups: proximal, alongside, and distal according to the anatomic relationship of the culprit lesion and the stent graft. Overall survival, reintervention-free survival, and extent of false lumen thrombosis were compared. RESULTS: The technical success rate was 97.2%. The 1-year, 3-year, and 5-year overall survival rates were 97.1%, 88.9%, and 88.9%, and 1-year, 3-year, and 5-year reintervention-free survival rates were 80.7%, 73.8%, and 60.6%. There were no differences in overall survival, reintervention-free survival rates, and extent of false lumen thrombosis between the groups. In the short coverage group, distal reintervention was more frequent in patients with an abdominal aortic diameter ≥ 37 mm compared with patients with an abdominal aortic diameter < 37 mm (P = .005). CONCLUSIONS: TEVAR was effective for CCBAD with a high technical success rate and low mortality. The extent of stent graft coverage did not make a difference in terms of survival and false lumen thrombosis. Reinterventions were more frequently performed in patients with a large baseline abdominal aortic diameter who were treated with short stent graft coverage, and so longer coverage is recommended in such patients.
URI
http://www.sciencedirect.com/science/article/pii/S1051044313011007

http://ir.ymlib.yonsei.ac.kr/handle/22282913/88136
DOI
10.1016/j.jvir.2013.06.007
Appears in Collections:
1. 연구논문 > 1. College of Medicine > Dept. of Thoracic & Cardiovascular Surgery
1. 연구논문 > 1. College of Medicine > Dept. of Internal Medicine
1. 연구논문 > 1. College of Medicine > Dept. of Radiology
Yonsei Authors
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