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Large false lumen area is a predictor of failed false lumen volume reduction after stent-graft repair in type B aortic dissection.

Authors
 Tae-Hoon Kim  ;  Young-Guk Ko  ;  Sung Woo Kwon  ;  Donghoon Choi  ;  Do Yun Lee  ;  Won-Heum Shim  ;  Min Su Hyon 
Citation
 JOURNAL OF ENDOVASCULAR THERAPY, Vol.21(5) : 697-706, 2014 
Journal Title
 JOURNAL OF ENDOVASCULAR THERAPY 
ISSN
 1526-6028 
Issue Date
2014
MeSH
Aged ; Aneurysm, Dissecting/diagnosis ; Aneurysm, Dissecting/mortality ; Aneurysm, Dissecting/surgery* ; Aortic Aneurysm, Thoracic/diagnosis ; Aortic Aneurysm, Thoracic/mortality ; Aortic Aneurysm, Thoracic/surgery* ; Aortography/methods ; Blood Vessel Prosthesis ; Blood Vessel Prosthesis Implantation*/adverse effects ; Blood Vessel Prosthesis Implantation*/instrumentation ; Blood Vessel Prosthesis Implantation*/mortality ; Endovascular Procedures*/adverse effects ; Endovascular Procedures*/instrumentation ; Endovascular Procedures*/mortality ; Female ; Humans ; Male ; Middle Aged ; Postoperative Complications/mortality ; Postoperative Complications/surgery ; Predictive Value of Tests ; Reoperation ; Retrospective Studies ; Risk Factors ; Stents ; Time Factors ; Tomography, X-Ray Computed ; Treatment Failure ; Vascular Remodeling
Keywords
aortic dissection ; aortic volume ; false lumen ; false lumen area ; mortality ; reintervention ; remodeling ; stent-graft ; thoracic endovascular aortic repair ; true lumen ; volume reduction
Abstract
Purpose: To investigate the predictors of failed false lumen (FL) volume reduction at 12 months after stent-graft implantation in patients with type B aortic dissection. Methods: The retrospective analysis comprised 38 patients (25 men; mean age 60±12 years) with double-barrel type B aortic dissection (9 acute) treated with thoracic endovascular aortic repair (TEVAR) and evaluated with serial computed tomography (CT) scans up to 12 months. Aortic volume changes were determined. Based on FL volume change at 1 year after stent-graft implantation, patients were dichotomized according to the presence or absence of FL volume reduction. Clinical and CT variables were compared between groups to determine risk factors of failed FL volume reduction. A major adverse event (MAE) was defined as death or reintervention. Results: Patients were followed for 4.2±2.8 years. FL volume reduction (+FLVR) occurred in 27 (71%) patients, whereas 11 (29%) patients had no FL volume reduction (–FLVR). The MAE-free survival rate was significantly higher in the +FLVR patients than in the –FLVR group (88.9% vs. 27.3%, respectively; p=0.001). Chronicity of dissection, location of tear site, or the maximum total aortic lumen area was not associated with failure to achieve FL volume reduction. However, the maximum preprocedure FL area was significantly lower in the +FLVR group than in the –FLVR group (12.6±6.6 vs. 21.0±11.4 cm2, respectively; p=0.041) and was an independent predictor for failed FL volume reduction (odds ratio 1.3, 95% confidence interval 1.02 to 1.70, p=0.031). Conclusion: Failed FL volume reduction after TEVAR was associated with a significantly increased rate of mortality or reintervention during follow-up. A larger preprocedure maximum FL area was a predictor of failed FL volume reduction after TEVAR in type B dissection.
Full Text
http://jevtonline.org/doi/abs/10.1583/14-4671MR.1
DOI
10.1583/14-4671MR.1
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Ko, Young Guk(고영국) ORCID logo https://orcid.org/0000-0001-7748-5788
Lee, Do Yun(이도연)
Choi, Dong Hoon(최동훈) ORCID logo https://orcid.org/0000-0002-2009-9760
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/100044
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