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Temporal pattern of aortic remodelling after endovascular treatment for chronic DeBakey IIIb dissection

Authors
 Tae-Hoon Kim  ;  Suk-Won Song  ;  Woon Heo  ;  Kwang-Hun Lee  ;  Kyung-Jong Yoo  ;  Hye Sun Lee  ;  Bum-Koo Cho 
Citation
 INTERACTIVE CARDIOVASCULAR AND THORACIC SURGERY, Vol.31(2) : 232-238, 2020-05 
Journal Title
 INTERACTIVE CARDIOVASCULAR AND THORACIC SURGERY 
ISSN
 1569-9293 
Issue Date
2020-05
Keywords
Chronic DeBakey IIIb ; Endovascular ; Longitudinal ; Remodelling ; Thoracic endovascular aortic repair
Abstract
Objectives: Endovascular treatment has emerged as a safe procedure for treating chronic DeBakey IIIb dissection. The objective of this study was to investigate the mid-term outcome and temporal pattern of aortic remodelling after endovascular treatment for DeBakey IIIb dissection. Methods: From 2012 to 2017, 85 patients who underwent endovascular aortic repair for DeBakey IIIb dissection were enrolled. The temporal pattern of aortic remodelling in terms of false lumen (FL) thrombosis [level 1 (∼T7), level 2 (T7 ∼ coeliac axis) and level 3 (coeliac trunk ∼ aortic bifurcation)] and aortic diameter [mid-thoracic level (T7), coeliac axis and the largest infrarenal abdominal aorta] was investigated on serial follow-up computed tomography scan. Results: Eighty-five patients underwent endovascular treatment during the study period. Male sex was a significant risk factor for repetitive reintervention and segments 2 and 3 FL thrombosis. The preoperative FL diameter at T7 was significantly associated with FL diameter regression. The number of visceral vessels from the FL and residual DeBakey IIIb dissection after type A repair were significant factors for FL growth at the coeliac trunk and at the largest infrarenal abdominal aorta. The overall mortality was 3 (3.6%). Conclusions: Endovascular treatment is a safe strategy in the management of DeBakey IIIb dissection. However, unfavourable aortic remodelling and repetitive reintervention were expected in male patients with a large number of visceral vessels from the FL and residual DeBakey IIIb dissection after type A repair. Endovascular treatment should be cautiously considered, and close follow-up is required for these patients.
Full Text
https://academic.oup.com/icvts/article/31/2/232/5842176
DOI
10.1093/icvts/ivaa070
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Thoracic and Cardiovascular Surgery (흉부외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Yonsei Biomedical Research Center (연세의생명연구원) > 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)
Lee, Hye Sun(이혜선) ORCID logo https://orcid.org/0000-0001-6328-6948
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/179275
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