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Complete Thoracic Aorta Remodeling After Endovascular Aortic Repair: A New Therapeutic Goal for Chronic DeBakey IIIb Aneury는

Authors
 Tae-Hoon Kim  ;  Suk-Won Song  ;  Woon Heo  ;  Kwang-Hun Lee  ;  Kyung-Jong Yoo  ;  Bum-Koo Cho 
Citation
 SEMINARS IN THORACIC AND CARDIOVASCULAR SURGERY, Vol.31(3) : 444-450, 2019-09 
Journal Title
 SEMINARS IN THORACIC AND CARDIOVASCULAR SURGERY 
ISSN
 1043-0679 
Issue Date
2019-09
MeSH
Aged ; Aneurysm, Dissecting / diagnostic imaging ; Aneurysm, Dissecting / mortality ; Aneurysm, Dissecting / physiopathology ; Aneurysm, Dissecting / surgery* ; Aorta, Thoracic / diagnostic imaging ; Aorta, Thoracic / physiopathology ; Aorta, Thoracic / surgery* ; Aortic Aneurysm, Thoracic / diagnostic imaging ; Aortic Aneurysm, Thoracic / mortality ; Aortic Aneurysm, Thoracic / physiopathology ; Aortic Aneurysm, Thoracic / surgery* ; Blood Vessel Prosthesis Implantation* / adverse effects ; Blood Vessel Prosthesis Implantation* / mortality ; Chronic Disease ; Endovascular Procedures* / adverse effects ; Endovascular Procedures* / mortality ; Female ; Humans ; Male ; Middle Aged ; Registries ; Retrospective Studies ; Risk Factors ; Thrombosis ; Time Factors ; Treatment Outcome ; Vascular Remodeling*
Keywords
Aortic dissection ; Chronic DeBakey IIIb
Abstract
To introduce complete thoracic aorta remodeling as a new therapeutic target of thoracic endovascular aortic repair for chronic DeBakey IIIb aneurysms, and analyze the predictors for complete thoracic aorta remodeling. From 2012 to 2017, 75 patients underwent thoracic endovascular aortic repair for chronic DeBakey IIIb aneurysms. Complete thoracic aorta remodeling was defined as thoracic false lumen thrombosis with false lumen diameter <5 mm down to T-10 level. Major adverse aortic events were defined as aortic-related mortality, open conversion, and false lumen recanalization after thoracic false lumen thrombosis. Of the 75 patients included in this study, 60 (80.0%) demonstrated thoracic false lumen thrombosis; among them, overall mortality, open conversion, or false lumen recanalization after thoracic false lumen thrombosis occurred in two (3.3%), one (1.7%), and five (8.3%) patients, respectively. Nineteen (25.3%) of 75 patients who demonstrated complete thoracic aorta remodeling had no major adverse aortic events during follow-up. The number of visceral branches from the false lumen and residual intima tears were significant risk factors for complete thoracic aorta remodeling (HR 0.627, p = 0.041 and HR 0.754, p = 0.042). In chronic DeBakey IIIb aneurysms, complete thoracic aorta remodeling may be the ideal target for endovascular treatment rather than false lumen thrombosis. Additional procedures to eliminate the obstacles to complete thoracic aorta remodeling (number of visceral branches from the false lumen and residual intimal tears) and close follow-up after thoracic false lumen thrombosis may be needed to achieve the optimal outcome.
Full Text
https://www.sciencedirect.com/science/article/pii/S1043067919300279
DOI
10.1053/j.semtcvs.2019.05.016
Appears in Collections:
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
Yonsei Authors
Kim, Tae Hoon(김태훈) ORCID logo https://orcid.org/0000-0003-3987-0057
Song, Suk Won(송석원) ORCID logo https://orcid.org/0000-0002-9850-9707
Yoo, Kyung Jong(유경종) ORCID logo https://orcid.org/0000-0002-9858-140X
Lee, Kwang Hun(이광훈)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/175894
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