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Predictors of Outco...
Predictors of Outcome after Endovascular Repair for Chronic Type B Dissection
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- Mani, Kevin (author)
- Uppsala universitet,Kärlkirurgi
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Clough, R. E. (author)
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Lyons, O. T. A. (author)
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Bell, R. E. (author)
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Carrell, T. W. (author)
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Zayed, H. A. (author)
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Waltham, M. (author)
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Taylor, P. R. (author)
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(creator_code:org_t)
- Elsevier BV, 2012
- 2012
- English.
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In: European Journal of Vascular and Endovascular Surgery. - : Elsevier BV. - 1078-5884 .- 1532-2165. ; 43:4, s. 386-391
- Related links:
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http://www.ejves.com...
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
Subject headings
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- Objectives: To assess the durability of endovascular repair (TEVAR) in chronic type B dissection (CD) and identify factors predictive of outcome. Design: Retrospective analysis of a prospective database. Materials: Patients undergoing TEVAR for CD at a tertiary referral centre 2000-2010. Methods: Analysis of pre-operative characteristics, operative outcome, false lumen thrombosis, aortic diameter and survival. Results: 58 consecutive patients were included (49 elective, 9 urgent, mean age 66 years). Mean aortic diameter was 6.4 cm (Standard deviation SD 1.3 cm). Three patients died perioperatively (5%, 1 urgent, 2 elective). Complications included retrograde type A dissection (n = 3), paraplegia (1), and transient ischaemic attack (1). Estimated survival (Kaplan-Meier) was 89% (1-year) and 64% (3-years). Forty-seven patients had mid-term imaging follow-up at mean 38 months. Reintervention rate was 15% at 1-year and 29% at 3-years. Aortic diameter decreased in 24, was stable in 15 and increased in 8. Mid-term survival was higher in patients with aortic remodelling (reduction of aortic diameter >0.5 cm; 3-year 89%) than without (54%; Log Rank p = 0.005). Remodelling occurred with extensive false lumen thrombosis. Conclusion: Satisfactory mid-term outcome after TEVAR for CD remains a challenge. Survival is associated with aortic remodelling, which is related to persistence of flow in the false lumen.
Keyword
- Aortic dissection
- Endovascular treatment
- Outcome
Publication and Content Type
- ref (subject category)
- art (subject category)
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