Late Aortic Remodeling after Endovascular Repair of Complicated Type B Aortic Dissection—TEVAR Protects Only the Covered Segment of Thoracic Aorta - Publication - Bridge of Knowledge

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Late Aortic Remodeling after Endovascular Repair of Complicated Type B Aortic Dissection—TEVAR Protects Only the Covered Segment of Thoracic Aorta

Abstract

Introduction: TEVAR is the preferred way of treatment of complicated type B aortic dissection. The purpose of the study was to assess the impact of TEVAR on aortic remodelling in the thoracic and abdominal segment in long-term follow-up. Methods: 23 patients with complicated type B aortic dissection were treated by TEVAR in years 2004-2012 in our Department. Aortic remodelling was rated based on preoperative and final follow-up CT angiography. Aorta was measured at the level of left bronchus (A), at the level of the diaphragm (B), celiac trunk (C) and the aorta below the renal arteries (D). Diameter of the aorta (da), total aortic area (taa), true lumen area (tla) and false lumen area(fla) were measured. Results: Primary technical success was obtained in 100%. Primary clinical success rate was 82.6%. Early mortality was 13 % (3 patients). Mean follow-up was 57,9 months (26 - 123, SD ± 30.5). All patients remain in the follow-up. Diameter of the aorta increased significantly only at the B level - from baseline 35,6 mm to 40,5 mm in the follow-up (p=0,005). Total aortic area (taa) was stable only at the A level but increased significantly at the B,C,D level. Area of the true lumen (tla) increased significantly at A,B,C,D levels, area of false lumen (fla) decreased significantly at A,B level but the area of false lumen (fla) didn't change at C and D level. Conclusion: TEVAR for complicated acute aortic type B dissection is safe and effective method of protecting thoracic aorta. The procedure was effective in majority of patients, and in 80% of the cases there was no need for additional distal aortic coverage. The abdominal aorta is relatively stable over a long period of observation in complicated type B aortic dissection.

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Category:
Articles
Type:
artykuł w czasopiśmie wyróżnionym w JCR
Published in:
ANNALS OF VASCULAR SURGERY no. 55, pages 148 - 156,
ISSN: 0890-5096
Language:
English
Publication year:
2019
Bibliographic description:
Wojciechowski J., Znaniecki L., Kaszubowski M. F., Rogowski J.: Late Aortic Remodeling after Endovascular Repair of Complicated Type B Aortic Dissection—TEVAR Protects Only the Covered Segment of Thoracic Aorta// ANNALS OF VASCULAR SURGERY. -Vol. 55, (2019), s.148-156
DOI:
Digital Object Identifier (open in new tab) 10.1016/j.avsg.2018.05.057
Verified by:
Gdańsk University of Technology

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