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Outcomes of Endovascular Management for Complicated Chronic Type B Aortic Dissection: Effect of the Extent of Stent Graft Coverage and Anatomic Properties of Aortic Dissection

Authors
 Myungsu Lee  ;  Do Yun Lee  ;  Man Deuk Kim  ;  Mu Sook Lee  ;  Jong Yun Won  ;  Sung Il Park  ;  Young Nam Yoon  ;  Sak Lee  ;  Donghoon Choi  ;  Young-Guk Ko 
Citation
 JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY, Vol.24(10) : 1451-1460, 2013 
Journal Title
 JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY 
ISSN
 1051-0443 
Issue Date
2013
MeSH
Adult ; Aged ; Aged, 80 and over ; Aneurysm, Dissecting/mortality* ; Aneurysm, Dissecting/surgery* ; Aortic Aneurysm/mortality* ; Aortic Aneurysm/surgery* ; Blood Vessel Prosthesis/statistics & numerical data* ; Chronic Disease ; Comorbidity ; Disease-Free Survival ; Endovascular Procedures/mortality* ; Female ; Humans ; Male ; Middle Aged ; Postoperative Complications/mortality ; Prevalence ; Republic of Korea/epidemiology ; Retrospective Studies ; Risk Factors ; Stents/statistics & numerical data* ; Survival Rate ; Treatment Outcome
Keywords
CCBAD ; IQR ; ROC ; TEVAR ; complicated chronic type B aortic dissection ; interquartile range ; receiver operating characteristics ; thoracic endovascular aortic repair
Abstract
PURPOSE: To assess the effect of the extent of stent graft coverage and anatomic properties of aortic dissection on the outcomes of thoracic endovascular aortic repair (TEVAR) for complicated chronic type B aortic dissection (CCBAD) in terms of survival, reintervention, and false lumen thrombosis. MATERIALS AND METHODS: A retrospective analysis was performed of 71 patients who underwent TEVAR for CCBAD. Mean patient age was 54.7 years. Distal extent of stent graft coverage was categorized as short (≤ T7) or long (≥ T8) coverage. Indications of reintervention were categorized into three groups: proximal, alongside, and distal according to the anatomic relationship of the culprit lesion and the stent graft. Overall survival, reintervention-free survival, and extent of false lumen thrombosis were compared. RESULTS: The technical success rate was 97.2%. The 1-year, 3-year, and 5-year overall survival rates were 97.1%, 88.9%, and 88.9%, and 1-year, 3-year, and 5-year reintervention-free survival rates were 80.7%, 73.8%, and 60.6%. There were no differences in overall survival, reintervention-free survival rates, and extent of false lumen thrombosis between the groups. In the short coverage group, distal reintervention was more frequent in patients with an abdominal aortic diameter ≥ 37 mm compared with patients with an abdominal aortic diameter < 37 mm (P = .005). CONCLUSIONS: TEVAR was effective for CCBAD with a high technical success rate and low mortality. The extent of stent graft coverage did not make a difference in terms of survival and false lumen thrombosis. Reinterventions were more frequently performed in patients with a large baseline abdominal aortic diameter who were treated with short stent graft coverage, and so longer coverage is recommended in such patients.
Full Text
http://www.sciencedirect.com/science/article/pii/S1051044313011007
DOI
10.1016/j.jvir.2013.06.007
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 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
Kim, Man Deuk(김만득) ORCID logo https://orcid.org/0000-0002-3575-5847
Park, Sung Il(박성일)
Won, Jong Yun(원종윤) ORCID logo https://orcid.org/0000-0002-8237-5628
Youn, Young Nam(윤영남)
Lee, Do Yun(이도연)
Lee, Myung Su(이명수)
Lee, Mu Sook(이무숙)
Lee, Sak(이삭) ORCID logo https://orcid.org/0000-0001-6130-2342
Choi, Dong Hoon(최동훈) ORCID logo https://orcid.org/0000-0002-2009-9760
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/88136
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