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CardioVascular and Interventional Radiology

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01-05-2017 | Clinical Investigation

Factors Affecting Optimal Aortic Remodeling After Thoracic Endovascular Aortic Repair of Type B (IIIb) Aortic Dissection

Authors: I-Ming Chen, Po-Lin Chen, Chun-Yang Huang, Shih-Hsien Weng, Wei-Yuan Chen, Chun-Che Shih

Published in: CardioVascular and Interventional Radiology | Issue 5/2017

Abstract

Purpose

The purpose of this study was to determine factors associated with entire aortic remodeling after thoracic endovascular aortic repair (TEVAR) in patients with type B dissection.

Materials and Methods

The patients with type B (IIIb) dissections who underwent TEVAR from 2006 to 2013 with minimum of 2 years of follow-up computed tomography data were retrospectively reviewed. Based on the status of false lumen remodeling of entire aorta, patients were divided into three groups: complete regression, total thrombosis, and inadequate regression with patent abdominal false lumen.

Results

A total of 90 patients (72 males, 18 females; mean age 56.6 ± 16.4 years) were included and divided into the complete regression (n = 22), total thrombosis (n = 18), and inadequate regression (n = 50) groups. Multivariate logistic regression analysis indicated that dissection extension to iliac arteries, increased preoperative number of dissection tear over abdominal aorta, and decreased preoperative abdominal aorta bifurcation true lumen ratio, as compared between the inadequate and complete regression groups, were associated with a persistent false lumen (odds ratio = 33.33, 2.304, and 0.021; all, p ≤ 0.012). Comparison of 6, 12, and 24 months postoperative data revealed no significant differences at any level, suggesting that the true lumen area ratio might not change after 6 months postoperatively.

Conclusions

Increased preoperative numbers of dissection tear around the abdominal visceral branches, dissection extension to the iliac arteries, and decreased preoperative true lumen area ratio of abdominal aorta are predictive of entire aortic remodeling after TEVAR in patients with type B dissection.

Level of Evidence

III.

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Title: Factors Affecting Optimal Aortic Remodeling After Thoracic Endovascular Aortic Repair of Type B (IIIb) Aortic Dissection
Authors: I-Ming Chen
Po-Lin Chen
Chun-Yang Huang
Shih-Hsien Weng
Wei-Yuan Chen
Chun-Che Shih
Publication date: 01-05-2017
Publisher: Springer US
Published in: CardioVascular and Interventional Radiology / Issue 5/2017
Print ISSN: 0174-1551
Electronic ISSN: 1432-086X
DOI: https://doi.org/10.1007/s00270-017-1563-y

At a glance: The STEP trials

Springer Medicine

Factors Affecting Optimal Aortic Remodeling After Thoracic Endovascular Aortic Repair of Type B (IIIb) Aortic Dissection

Abstract

Purpose

Materials and Methods

Results

Conclusions

Level of Evidence

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Materials and Methods

Results

Conclusions

Level of Evidence

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