Outcomes of endovascular management for complicated chronic type b aortic dissection

Effect of the extent of stent graft coverage and anatomic properties of aortic dissection

Myungsu Lee, Do Yun Lee, ManDeuk Kim, Mu Sook Lee, Jong Yun Won, Sung Il Park, Young Nam Yoon, Sak Lee, Donghoon Choi, Young Guk Ko

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

Purpose: To assess the effect of the extent of stent graft coverage and anatomic properties of aortic dissection on the outcomes of thoracic endovascular aortic repair (TEVAR) for complicated chronic type B aortic dissection (CCBAD) in terms of survival, reintervention, and false lumen thrombosis. Materials and Methods: A retrospective analysis was performed of 71 patients who underwent TEVAR for CCBAD. Mean patient age was 54.7 years. Distal extent of stent graft coverage was categorized as short (≤ T7) or long (≥ T8) coverage. Indications of reintervention were categorized into three groups: proximal, alongside, and distal according to the anatomic relationship of the culprit lesion and the stent graft. Overall survival, reintervention-free survival, and extent of false lumen thrombosis were compared. Results: The technical success rate was 97.2%. The 1-year, 3-year, and 5-year overall survival rates were 97.1%, 88.9%, and 88.9%, and 1-year, 3-year, and 5-year reintervention-free survival rates were 80.7%, 73.8%, and 60.6%. There were no differences in overall survival, reintervention-free survival rates, and extent of false lumen thrombosis between the groups. In the short coverage group, distal reintervention was more frequent in patients with an abdominal aortic diameter ≥ 37 mm compared with patients with an abdominal aortic diameter < 37 mm (P =.005). Conclusions: TEVAR was effective for CCBAD with a high technical success rate and low mortality. The extent of stent graft coverage did not make a difference in terms of survival and false lumen thrombosis. Reinterventions were more frequently performed in patients with a large baseline abdominal aortic diameter who were treated with short stent graft coverage, and so longer coverage is recommended in such patients.

Original languageEnglish
Pages (from-to)1451-1460
Number of pages10
JournalJournal of Vascular and Interventional Radiology
Volume24
Issue number10
DOIs
Publication statusPublished - 2013 Oct 1

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Stents
Dissection
Transplants
Thrombosis
Survival
Thorax
Survival Rate
Mortality

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

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title = "Outcomes of endovascular management for complicated chronic type b aortic dissection: Effect of the extent of stent graft coverage and anatomic properties of aortic dissection",
abstract = "Purpose: To assess the effect of the extent of stent graft coverage and anatomic properties of aortic dissection on the outcomes of thoracic endovascular aortic repair (TEVAR) for complicated chronic type B aortic dissection (CCBAD) in terms of survival, reintervention, and false lumen thrombosis. Materials and Methods: A retrospective analysis was performed of 71 patients who underwent TEVAR for CCBAD. Mean patient age was 54.7 years. Distal extent of stent graft coverage was categorized as short (≤ T7) or long (≥ T8) coverage. Indications of reintervention were categorized into three groups: proximal, alongside, and distal according to the anatomic relationship of the culprit lesion and the stent graft. Overall survival, reintervention-free survival, and extent of false lumen thrombosis were compared. Results: The technical success rate was 97.2{\%}. The 1-year, 3-year, and 5-year overall survival rates were 97.1{\%}, 88.9{\%}, and 88.9{\%}, and 1-year, 3-year, and 5-year reintervention-free survival rates were 80.7{\%}, 73.8{\%}, and 60.6{\%}. There were no differences in overall survival, reintervention-free survival rates, and extent of false lumen thrombosis between the groups. In the short coverage group, distal reintervention was more frequent in patients with an abdominal aortic diameter ≥ 37 mm compared with patients with an abdominal aortic diameter < 37 mm (P =.005). Conclusions: TEVAR was effective for CCBAD with a high technical success rate and low mortality. The extent of stent graft coverage did not make a difference in terms of survival and false lumen thrombosis. Reinterventions were more frequently performed in patients with a large baseline abdominal aortic diameter who were treated with short stent graft coverage, and so longer coverage is recommended in such patients.",
author = "Myungsu Lee and Lee, {Do Yun} and ManDeuk Kim and Lee, {Mu Sook} and Won, {Jong Yun} and Park, {Sung Il} and Yoon, {Young Nam} and Sak Lee and Donghoon Choi and Ko, {Young Guk}",
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Outcomes of endovascular management for complicated chronic type b aortic dissection : Effect of the extent of stent graft coverage and anatomic properties of aortic dissection. / Lee, Myungsu; Lee, Do Yun; Kim, ManDeuk; Lee, Mu Sook; Won, Jong Yun; Park, Sung Il; Yoon, Young Nam; Lee, Sak; Choi, Donghoon; Ko, Young Guk.

In: Journal of Vascular and Interventional Radiology, Vol. 24, No. 10, 01.10.2013, p. 1451-1460.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Outcomes of endovascular management for complicated chronic type b aortic dissection

T2 - Effect of the extent of stent graft coverage and anatomic properties of aortic dissection

AU - Lee, Myungsu

AU - Lee, Do Yun

AU - Kim, ManDeuk

AU - Lee, Mu Sook

AU - Won, Jong Yun

AU - Park, Sung Il

AU - Yoon, Young Nam

AU - Lee, Sak

AU - Choi, Donghoon

AU - Ko, Young Guk

PY - 2013/10/1

Y1 - 2013/10/1

N2 - Purpose: To assess the effect of the extent of stent graft coverage and anatomic properties of aortic dissection on the outcomes of thoracic endovascular aortic repair (TEVAR) for complicated chronic type B aortic dissection (CCBAD) in terms of survival, reintervention, and false lumen thrombosis. Materials and Methods: A retrospective analysis was performed of 71 patients who underwent TEVAR for CCBAD. Mean patient age was 54.7 years. Distal extent of stent graft coverage was categorized as short (≤ T7) or long (≥ T8) coverage. Indications of reintervention were categorized into three groups: proximal, alongside, and distal according to the anatomic relationship of the culprit lesion and the stent graft. Overall survival, reintervention-free survival, and extent of false lumen thrombosis were compared. Results: The technical success rate was 97.2%. The 1-year, 3-year, and 5-year overall survival rates were 97.1%, 88.9%, and 88.9%, and 1-year, 3-year, and 5-year reintervention-free survival rates were 80.7%, 73.8%, and 60.6%. There were no differences in overall survival, reintervention-free survival rates, and extent of false lumen thrombosis between the groups. In the short coverage group, distal reintervention was more frequent in patients with an abdominal aortic diameter ≥ 37 mm compared with patients with an abdominal aortic diameter < 37 mm (P =.005). Conclusions: TEVAR was effective for CCBAD with a high technical success rate and low mortality. The extent of stent graft coverage did not make a difference in terms of survival and false lumen thrombosis. Reinterventions were more frequently performed in patients with a large baseline abdominal aortic diameter who were treated with short stent graft coverage, and so longer coverage is recommended in such patients.

AB - Purpose: To assess the effect of the extent of stent graft coverage and anatomic properties of aortic dissection on the outcomes of thoracic endovascular aortic repair (TEVAR) for complicated chronic type B aortic dissection (CCBAD) in terms of survival, reintervention, and false lumen thrombosis. Materials and Methods: A retrospective analysis was performed of 71 patients who underwent TEVAR for CCBAD. Mean patient age was 54.7 years. Distal extent of stent graft coverage was categorized as short (≤ T7) or long (≥ T8) coverage. Indications of reintervention were categorized into three groups: proximal, alongside, and distal according to the anatomic relationship of the culprit lesion and the stent graft. Overall survival, reintervention-free survival, and extent of false lumen thrombosis were compared. Results: The technical success rate was 97.2%. The 1-year, 3-year, and 5-year overall survival rates were 97.1%, 88.9%, and 88.9%, and 1-year, 3-year, and 5-year reintervention-free survival rates were 80.7%, 73.8%, and 60.6%. There were no differences in overall survival, reintervention-free survival rates, and extent of false lumen thrombosis between the groups. In the short coverage group, distal reintervention was more frequent in patients with an abdominal aortic diameter ≥ 37 mm compared with patients with an abdominal aortic diameter < 37 mm (P =.005). Conclusions: TEVAR was effective for CCBAD with a high technical success rate and low mortality. The extent of stent graft coverage did not make a difference in terms of survival and false lumen thrombosis. Reinterventions were more frequently performed in patients with a large baseline abdominal aortic diameter who were treated with short stent graft coverage, and so longer coverage is recommended in such patients.

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