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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
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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
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Journal Article
Large False Lumen Area Is a Predictor of Failed False Lumen Volume Reduction After Stent-Graft Repair in Type B Aortic Dissection
2014
Overview
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
60±12 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.
Publisher
SAGE Publications,Allen Press Inc
Subject
/ Aneurysm, Dissecting - diagnosis
/ Aneurysm, Dissecting - mortality
/ Aneurysm, Dissecting - surgery
/ Aortic Aneurysm, Thoracic - diagnosis
/ Aortic Aneurysm, Thoracic - mortality
/ Aortic Aneurysm, Thoracic - surgery
/ Blood Vessel Prosthesis Implantation - adverse effects
/ Blood Vessel Prosthesis Implantation - instrumentation
/ Blood Vessel Prosthesis Implantation - mortality
/ Endovascular Procedures - adverse effects
/ Endovascular Procedures - instrumentation
/ Endovascular Procedures - mortality
/ Female
/ Humans
/ Male
/ Postoperative Complications - mortality
/ Postoperative Complications - surgery
/ Stents
/ Studies
