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Endovascular Repair...
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Brunkwall, J.Dept Vasc & Endovasc Surg, Univ Clin, Univ Cologne, Cologne, Germany
(author)
Endovascular Repair of Acute Uncomplicated Aortic Type B Dissection Promotes Aortic Remodelling: 1 Year Results of the ADSORB Trial
- Article/chapterEnglish2014
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LIBRIS-ID:oai:lup.lub.lu.se:683abecc-2f97-4bd2-866c-adc8efe8bc71
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https://lup.lub.lu.se/record/4709982URI
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https://doi.org/10.1016/j.ejvs.2014.05.012DOI
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https://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-56349URI
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Language:English
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Summary in:English
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Subject category:art swepub-publicationtype
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Subject category:ref swepub-contenttype
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Funding Agency:WLGoreNote: "ADSORB Trialists":P. Alric and L. Canaud, CHU Arnaud de Villeneuve, Montpeiller; M. Janotta, Section of Vascular Surgery, Department of Surgery, University of Regensburg; D. Raithel, Klinikum Nuernberg; M. Malina and Ti. Resch, Dept. Vascular Diseases, University Hospital, Malmö; H.-H. Eckstein and S. Ockert, Dept. Vascular Surgery TUM Munich; T. Larzon, Section of Vascular Surgery; F. Carlsson, Department of Cardiology, Örebro University Hospital, Örebro; H. Schumacher, S. Classen, and P. Schaub Dept. Vascular Surgery, Hanau; J. Lammer, Dept. Radiology, General Hospital, Vienna; L. Lönn, Dept. Vascular Surgery and Radiology, Rigshospitalet, Copenhagen; Rachel E. Clough, Dept. Vascular Surgery, St Guys Hospital, London; V. Rampoldi and S. Trimarchi, Policlinico San Donato, Milan; J.-N. Fabiani, APHP Hopital Europeen Georges Pompidou, Paris; D. Böckler and D. Kotelis, Dept. Vascular Surgery, University Clinics, Heidelberg; H. von Tenng-Kobligk, Dept. Radiology, University Clinics, Heidelberg; N. Mangialardi and S. Ronchey, Azienda Ospedaliera S. Filippo Neri, Rome; G. Dialetto, V. Monaldi Hospital, Naples; V. Matoussevitch, Department of Vascular and Endovascular Surgery, University Clinics, University of Cologne. ; ClinicalTrial.gov identifier: NCT00742274.
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Objectives: Uncomplicated acute type B aortic dissection (AD) treated conservatively has a 10% 30-day mortality and up to 25% need intervention within 4 years. In complicated AD, stent grafts have been encouraging. The aim of the present prospective randomised trial was to compare best medical treatment (BMT) with BMT and Gore TAG stent graft in patients with uncomplicated AD. The primary endpoint was a combination of incomplete/no false lumen thrombosis, aortic dilatation, or aortic rupture at 1 year. Methods: The AD history had to be less than 14 days, and exclusion criteria were rupture, impending rupture, malperfusion. Of the 61 patients randomised, 80% were DeBakey type IIIB. Results: Thirty-one patients were randomised to the BMT group and 30 to the BMT+TAG group. Mean age was 63 years for both groups. The left subclavian artery was completely covered in 47% and in part in 17% of the cases. During the first 30 days, no deaths occurred in either group, but there were three crossovers from the BMT to the BMT TAG group, all due to progression of disease within 1 week. There were two withdrawals from the BMT+TAG group. At the 1-year follow up there had been another two failures in the BMT group: one malperfusion and one aneurysm formation (p = .056 for all). One death occurred in the BMT TAG group. For the overall endpoint BMT+TAG was significantly different from BMT only (p < .001). Incomplete false lumen thrombosis, was found in 13 (43%) of the TAG+BMT group and 30 (97%) of the BMT group (p < .001). The false lumen reduced in size in the BMT+TAG group (p < .001) whereas in the BMT group it increased. The true lumen increased in the BMT TAG (p < .001) whereas in the BMT group it remained unchanged. The overall transverse diameter was the same at the beginning and after 1 year in the BMT group (42.1 mm), but in the BMT+TAG it decreased (38.8 mm; p = .062). Conclusions: Uncomplicated AD can be safely treated with the Gore TAG device. Remodelling with thrombosis of the false lumen and reduction of its diameter is induced by the stent graft, but long term results are needed. (C) 2014 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.
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Kasprzak, P.Dept Surg, Sect Vasc Surg, Klinikum Nurnberg,Dept Vasc Surg, Univ Regensburg, Nurnberg, Germany
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Verhoeven, E.Dept Cardiovasc Surg, Antonius Hosp, Nieuwegein, Netherlands
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Heijmen, R.Dept Vasc Surg, St Guys Hosp, London, England
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Taylor, P.Dept Vasc Surg, St Guys Hosp, London, England
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Alric, P.
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Canaud, L.
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Janotta, M.
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Raithel, D.
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Malina, MartinLund University,Lunds universitet,Vaskulära sjukdomar - kliniska studier,Forskargrupper vid Lunds universitet,Vascular Diseases - Clinical Research,Lund University Research Groups(Swepub:lu)kir-mma
(author)
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Resch, TimLund University,Lunds universitet,Vaskulära sjukdomar - kliniska studier,Forskargrupper vid Lunds universitet,Vascular Diseases - Clinical Research,Lund University Research Groups(Swepub:lu)med-tmr
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Eckstein, H. -H.
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Ockert, S.
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Larzon, T.
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Carlsson, F.
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Schumacher, H.
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Classen, S.
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Schaub, P.
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Lammer, J.
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Lonn, L.
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Clough, R. E.
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Rampoldi, V.
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Trimarchi, S.
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Fabiani, J. -N.
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Boeckler, D.
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Kotelis, D.
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Boeckler, D.
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Kotelis, D.
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von Tenng-Kobligk, H.
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Mangialardi, N.
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Ronchey, S.
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Dialetto, G.
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Matoussevitch, V.
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Dept Vasc & Endovasc Surg, Univ Clin, Univ Cologne, Cologne, GermanyDept Surg, Sect Vasc Surg, Klinikum Nurnberg,Dept Vasc Surg, Univ Regensburg, Nurnberg, Germany
(creator_code:org_t)
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In:European Journal of Vascular and Endovascular Surgery: Elsevier BV48:3, s. 285-2911532-21651078-5884
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Brunkwall, J.
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Kasprzak, P.
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Verhoeven, E.
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Heijmen, R.
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Taylor, P.
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Alric, P.
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Canaud, L.
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Janotta, M.
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Raithel, D.
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Malina, Martin
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Resch, Tim
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Eckstein, H. -H.
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Ockert, S.
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Larzon, T.
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Carlsson, F.
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Schumacher, H.
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Classen, S.
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Schaub, P.
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Lammer, J.
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Lonn, L.
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Clough, R. E.
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Rampoldi, V.
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Trimarchi, S.
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Fabiani, J. -N.
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Boeckler, D.
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Kotelis, D.
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von Tenng-Koblig ...
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Mangialardi, N.
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Ronchey, S.
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Dialetto, G.
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Matoussevitch, V ...
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and Surgery
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MEDICAL AND HEAL ...
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Lund University
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Örebro University