Large false lumen area is a predictor of failed false lumen volume reduction after stent-graft repair in type B aortic dissection

Tae Hoon Kim, Young Guk Ko, Sung Woo Kwon, Donghoon Choi, Do Yun Lee, Won Heum Shim, Min Su Hyon

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Purpose: To investigate the predictors of failed false lumen (FL) volume reduction at 12 months after stent-graft implantation in patients with type B aortic dissection.

Methods: The retrospective analysis comprised 38 patients (25 men; mean age 60612 years) with double-barrel type B aortic dissection (9 acute) treated with thoracic endovascular aortic repair (TEVAR) and evaluated with serial computed tomography (CT) scans up to 12 months. Aortic volume changes were determined. Based on FL volume change at 1 year after stent-graft implantation, patients were dichotomized according to the presence or absence of FL volume reduction. Clinical and CT variables were compared between groups to determine risk factors of failed FL volume reduction. A major adverse event (MAE) was defined as death or reintervention.

Results: Patients were followed for 4.2±2.8 years. FL volume reduction (+FLVR) occurred in 27 (71%) patients, whereas 11 (29%) patients had no FL volume reduction (-FLVR). The MAE-free survival rate was significantly higher in the +FLVR patients than in the -FLVR group (88.9% vs. 27.3%, respectively; p=0.001). Chronicity of dissection, location of tear site, or the maximum total aortic lumen area was not associated with failure to achieve FL volume reduction. However, the maximum preprocedure FL area was significantly lower in the +FLVR group than in the -FLVR group (12.6±6.6 vs. 21.0±11.4 cm2, respectively; p=0.041) and was an independent predictor for failed FL volume reduction (odds ratio 1.3, 95% confidence interval 1.02 to 1.70, p=0.031).

Conclusion: Failed FL volume reduction after TEVAR was associated with a significantly increased rate of mortality or reintervention during follow-up. A larger preprocedure maximum FL area was a predictor of failed FL volume reduction after TEVAR in type B dissection.

Original languageEnglish
Pages (from-to)697-706
Number of pages10
JournalJournal of Endovascular Therapy
Volume21
Issue number5
DOIs
Publication statusPublished - 2014 Oct 1

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Stents
Dissection
Transplants
Thorax
Tomography
Tears
Disease-Free Survival
Survival Rate
Odds Ratio
Confidence Intervals
Mortality

All Science Journal Classification (ASJC) codes

  • Surgery
  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

Kim, Tae Hoon ; Ko, Young Guk ; Kwon, Sung Woo ; Choi, Donghoon ; Lee, Do Yun ; Shim, Won Heum ; Hyon, Min Su. / Large false lumen area is a predictor of failed false lumen volume reduction after stent-graft repair in type B aortic dissection. In: Journal of Endovascular Therapy. 2014 ; Vol. 21, No. 5. pp. 697-706.
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title = "Large false lumen area is a predictor of failed false lumen volume reduction after stent-graft repair in type B aortic dissection",
abstract = "Purpose: To investigate the predictors of failed false lumen (FL) volume reduction at 12 months after stent-graft implantation in patients with type B aortic dissection.Methods: The retrospective analysis comprised 38 patients (25 men; mean age 60612 years) with double-barrel type B aortic dissection (9 acute) treated with thoracic endovascular aortic repair (TEVAR) and evaluated with serial computed tomography (CT) scans up to 12 months. Aortic volume changes were determined. Based on FL volume change at 1 year after stent-graft implantation, patients were dichotomized according to the presence or absence of FL volume reduction. Clinical and CT variables were compared between groups to determine risk factors of failed FL volume reduction. A major adverse event (MAE) was defined as death or reintervention.Results: Patients were followed for 4.2±2.8 years. FL volume reduction (+FLVR) occurred in 27 (71{\%}) patients, whereas 11 (29{\%}) patients had no FL volume reduction (-FLVR). The MAE-free survival rate was significantly higher in the +FLVR patients than in the -FLVR group (88.9{\%} vs. 27.3{\%}, respectively; p=0.001). Chronicity of dissection, location of tear site, or the maximum total aortic lumen area was not associated with failure to achieve FL volume reduction. However, the maximum preprocedure FL area was significantly lower in the +FLVR group than in the -FLVR group (12.6±6.6 vs. 21.0±11.4 cm2, respectively; p=0.041) and was an independent predictor for failed FL volume reduction (odds ratio 1.3, 95{\%} confidence interval 1.02 to 1.70, p=0.031).Conclusion: Failed FL volume reduction after TEVAR was associated with a significantly increased rate of mortality or reintervention during follow-up. A larger preprocedure maximum FL area was a predictor of failed FL volume reduction after TEVAR in type B dissection.",
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Large false lumen area is a predictor of failed false lumen volume reduction after stent-graft repair in type B aortic dissection. / Kim, Tae Hoon; Ko, Young Guk; Kwon, Sung Woo; Choi, Donghoon; Lee, Do Yun; Shim, Won Heum; Hyon, Min Su.

In: Journal of Endovascular Therapy, Vol. 21, No. 5, 01.10.2014, p. 697-706.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Large false lumen area is a predictor of failed false lumen volume reduction after stent-graft repair in type B aortic dissection

AU - Kim, Tae Hoon

AU - Ko, Young Guk

AU - Kwon, Sung Woo

AU - Choi, Donghoon

AU - Lee, Do Yun

AU - Shim, Won Heum

AU - Hyon, Min Su

PY - 2014/10/1

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N2 - Purpose: To investigate the predictors of failed false lumen (FL) volume reduction at 12 months after stent-graft implantation in patients with type B aortic dissection.Methods: The retrospective analysis comprised 38 patients (25 men; mean age 60612 years) with double-barrel type B aortic dissection (9 acute) treated with thoracic endovascular aortic repair (TEVAR) and evaluated with serial computed tomography (CT) scans up to 12 months. Aortic volume changes were determined. Based on FL volume change at 1 year after stent-graft implantation, patients were dichotomized according to the presence or absence of FL volume reduction. Clinical and CT variables were compared between groups to determine risk factors of failed FL volume reduction. A major adverse event (MAE) was defined as death or reintervention.Results: Patients were followed for 4.2±2.8 years. FL volume reduction (+FLVR) occurred in 27 (71%) patients, whereas 11 (29%) patients had no FL volume reduction (-FLVR). The MAE-free survival rate was significantly higher in the +FLVR patients than in the -FLVR group (88.9% vs. 27.3%, respectively; p=0.001). Chronicity of dissection, location of tear site, or the maximum total aortic lumen area was not associated with failure to achieve FL volume reduction. However, the maximum preprocedure FL area was significantly lower in the +FLVR group than in the -FLVR group (12.6±6.6 vs. 21.0±11.4 cm2, respectively; p=0.041) and was an independent predictor for failed FL volume reduction (odds ratio 1.3, 95% confidence interval 1.02 to 1.70, p=0.031).Conclusion: Failed FL volume reduction after TEVAR was associated with a significantly increased rate of mortality or reintervention during follow-up. A larger preprocedure maximum FL area was a predictor of failed FL volume reduction after TEVAR in type B dissection.

AB - Purpose: To investigate the predictors of failed false lumen (FL) volume reduction at 12 months after stent-graft implantation in patients with type B aortic dissection.Methods: The retrospective analysis comprised 38 patients (25 men; mean age 60612 years) with double-barrel type B aortic dissection (9 acute) treated with thoracic endovascular aortic repair (TEVAR) and evaluated with serial computed tomography (CT) scans up to 12 months. Aortic volume changes were determined. Based on FL volume change at 1 year after stent-graft implantation, patients were dichotomized according to the presence or absence of FL volume reduction. Clinical and CT variables were compared between groups to determine risk factors of failed FL volume reduction. A major adverse event (MAE) was defined as death or reintervention.Results: Patients were followed for 4.2±2.8 years. FL volume reduction (+FLVR) occurred in 27 (71%) patients, whereas 11 (29%) patients had no FL volume reduction (-FLVR). The MAE-free survival rate was significantly higher in the +FLVR patients than in the -FLVR group (88.9% vs. 27.3%, respectively; p=0.001). Chronicity of dissection, location of tear site, or the maximum total aortic lumen area was not associated with failure to achieve FL volume reduction. However, the maximum preprocedure FL area was significantly lower in the +FLVR group than in the -FLVR group (12.6±6.6 vs. 21.0±11.4 cm2, respectively; p=0.041) and was an independent predictor for failed FL volume reduction (odds ratio 1.3, 95% confidence interval 1.02 to 1.70, p=0.031).Conclusion: Failed FL volume reduction after TEVAR was associated with a significantly increased rate of mortality or reintervention during follow-up. A larger preprocedure maximum FL area was a predictor of failed FL volume reduction after TEVAR in type B dissection.

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