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The fate of the abdominal aorta after endovascular treatment in chronic Debakey IIIb aneurysm

 Tae-Hoon Kim  ;  Suk-Won Song  ;  Kwang-Hun Lee  ;  Min-Young Baek  ;  Kyung-Jong Yoo  ;  Hye Sun Lee 
 Journal of Thoracic and Cardiovascular Surgery, Vol.156(1) : 27-35, 2018 
Journal Title
 Journal of Thoracic and Cardiovascular Surgery 
Issue Date
chronic DeBakey IIIb ; the fate of abdominal aortic dissection ; thoracic endovascular aortic repair
OBJECTIVES: We sought to identify the risk factors for abdominal aortic remodeling after thoracic endovascular aortic repair in patients with chronic DeBakey IIIb aneurysm. METHODS: From 2012 to 2016, 70 patients underwent thoracic endovascular aortic repair for chronic DeBakey IIIb aneurysm. The abdominal aortic diameter was measured at 3 different levels (celiac trunk, renal artery, and infrarenal aorta). Abdominal aorta status was classified as expansion or stable. Expansion status was assigned when the abdominal aortic diameter was increased over 5 mm at least 1 level. Otherwise, it was classified as stable status. Forty-six of 70 patients underwent more than 2 postoperative imaging studies. In those patients (n = 46), abdominal aortic volume was measured from celiac trunk to inferior mesenteric artery. A linear mixed-effect model was used to analyze the overall fate of abdominal aortic volume. RESULTS: No in-hospital mortality occurred. The mean follow-up and imaging follow-up duration were 26 and 17 months, respectively. Sixty-one patients (87.1%) demonstrated thoracic false-lumen thrombosis. Although false-lumen thrombosis was achieved, 15 patients (24.6%) demonstrated the expansion status. In volumetric analysis, the total abdominal aortic volume was increasing over time (0.603 cm3/mo; P < .001) and the residual intima tears were identified as an independent anatomic risk factor for an enlarged abdominal aorta. CONCLUSIONS: An enlarged abdominal aorta in chronic DeBakey IIIb aneurysm can be frequently recognized even after successful endovascular treatment. The residual intima tears were the only identified risk factor for change in a dissected abdominal aneurysm. We suggest careful abdominal aorta evaluation and additional procedures on the false lumen if necessary.
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1. College of Medicine (의과대학) > Dept. of Thoracic and Cardiovascular Surgery (흉부외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Yonsei Biomedical Research Center (연세의생명연구원) > 1. Journal Papers
Yonsei Authors
김태훈(Kim, Tae Hoon) ORCID logo https://orcid.org/0000-0003-3987-0057
백민영(Baek, Min Young)
송석원(Song, Suk Won) ORCID logo https://orcid.org/0000-0002-9850-9707
유경종(Yoo, Kyung Jong) ORCID logo https://orcid.org/0000-0002-9858-140X
이광훈(Lee, Kwang Hun)
이혜선(Lee, Hye Sun) ORCID logo https://orcid.org/0000-0001-6328-6948
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