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

Journal Article · Mon May 15 04:00:00 EDT 2017 · Cardiovascular and Interventional Radiology

DOI:https://doi.org/10.1007/S00270-017-1563-Y· OSTI ID:22645216

Chen, I-Ming ^[1]; Chen, Po-Lin; Huang, Chun-Yang ^[2]; Weng, Shih-Hsien; Chen, Wei-Yuan; Shih, Chun-Che ^[1]

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1. National Yang Ming University, Institute of Clinical Medicine, School of Medicine (China)
2. National Yang Ming University, Department of Medicine, School of Medicine (China)

PurposeThe 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 MethodsThe 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.ResultsA 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.ConclusionsIncreased 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 EvidenceIII.

• OSTI ID: 22645216
• Journal Information: Cardiovascular and Interventional Radiology, Journal Name: Cardiovascular and Interventional Radiology Journal Issue: 5 Vol. 40; ISSN 0174-1551; ISSN CAIRDG
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
AORTA
COMPARATIVE EVALUATIONS
COMPUTERIZED TOMOGRAPHY
MULTIVARIATE ANALYSIS
NITROGEN 18
NITROGEN 22
PATENTS
PATIENTS
REGRESSION ANALYSIS
REPAIR
REVIEWS
THROMBOSIS