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Comparative Outcome Analysis of N-Butyl Cyanoacrylate Embolization of the False Lumen Versus Thoracic Endovascular Aortic Repair in Aortic Dissection

Authors
 Dong Kyu Kim  ;  Joon Ho Kwon  ;  Heung Kyu Ko  ;  Junhyung Lee  ;  Kichang Han  ;  Gyoung Min Kim  ;  Man-Deuk Kim  ;  Jong Yun Won  ;  Hyun-Chel Joo  ;  Young-Guk Ko  ;  Do Yun Lee 
Citation
 JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY, Vol.32(1) : 39-48, 2021-01 
Journal Title
 JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY 
ISSN
 1051-0443 
Issue Date
2021-01
MeSH
Adult ; Aged ; Aged, 80 and over ; Aneurysm, Dissecting / diagnostic imaging ; Aneurysm, Dissecting / mortality ; Aneurysm, Dissecting / therapy* ; Aortic Aneurysm, Thoracic / diagnostic imaging ; Aortic Aneurysm, Thoracic / mortality ; Aortic Aneurysm, Thoracic / therapy* ; Blood Vessel Prosthesis Implantation* / adverse effects ; Blood Vessel Prosthesis Implantation* / mortality ; Comparative Effectiveness Research ; Embolization, Therapeutic* / adverse effects ; Embolization, Therapeutic* / mortality ; Enbucrilate / administration & dosage* ; Enbucrilate / adverse effects ; Endovascular Procedures* / adverse effects ; Endovascular Procedures* / mortality ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Time Factors ; Treatment Outcome
Abstract
Purpose: To evaluate the feasibility, safety, and effectiveness of N-butyl cyanoacrylate (NBCA) embolization for the treatment of aortic dissection. Materials and methods: In this single-center retrospective study conducted from February 2003 to June 2019, NBCA embolization of an aortic false lumen was attempted in 12 patients (median age, 59 y; range, 41-68 y) and thoracic endovascular aortic repair (TEVAR) was performed in 53 patients (median age, 59 y; range, 37-70 y) for aortic dissection with one or more indications of persisting pain, malperfusion, rupture or impending rupture, maximal aortic diameter ≥ 55 mm, and/or rapid aortic enlargement. The main exclusion criterion for embolization was the presence of fast blood flow in the aortic false lumen on aortography. The efficacy of NBCA embolization and TEVAR was compared by evaluating technical and clinical outcomes, repeat intervention-free survival (RFS), and overall survival (OS). Results: Technical success was achieved in 11 of the 12 patients treated with NBCA embolization (91.7%), and clinical success was achieved in 9 of these 11 (81.8%). No significant difference was found between embolization and TEVAR in clinical success rates (embolization, 81.8%; TEVAR, 84.9%; P = .409) or procedure-related complications (embolization, 1 patient [8.3%]; TEVAR, 4 patients [7.5%]; P = .701). In addition, embolization showed comparable 5-y RFS (embolization, 82.5% ± 9.3; TEVAR, 85.5% ± 4.8; P = .641) and 5-y OS (embolization, 100%; TEVAR, 95.4% ± 3.2; P = .744) rates to TEVAR. Conclusions: NBCA embolization of the false lumen in aortic dissection seems to be a safe and effective treatment modality for the closure of false lumen in selected patients.
Full Text
https://www.sciencedirect.com/science/article/pii/S105104432030765X
DOI
10.1016/j.jvir.2020.08.037
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
1. College of Medicine (의과대학) > Dept. of Thoracic and Cardiovascular Surgery (흉부외과학교실) > 1. Journal Papers
Yonsei Authors
Ko, Young Guk(고영국) ORCID logo https://orcid.org/0000-0001-7748-5788
Kwon, Joon Ho(권준호) ORCID logo https://orcid.org/0000-0002-6178-7252
Kim, Gyoung Min(김경민) ORCID logo https://orcid.org/0000-0001-6768-4396
Kim, Dong Kyu(김동규) ORCID logo https://orcid.org/0000-0001-7322-2550
Kim, Man Deuk(김만득) ORCID logo https://orcid.org/0000-0002-3575-5847
Won, Jong Yun(원종윤) ORCID logo https://orcid.org/0000-0002-8237-5628
Lee, Junhyung(이준형) ORCID logo https://orcid.org/0000-0002-1942-5485
Joo, Hyun Chel(주현철) ORCID logo https://orcid.org/0000-0002-6842-2942
Han, Ki Chang(한기창) ORCID logo https://orcid.org/0000-0002-9701-9757
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/182443
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