Endovascular Repair of Acute Type B Aortic Dissection:Midterm Results

Abstract

Serious complications can occur during and after endovascular repair of TBD. Therefore, it should be reserved for high-risk patients.

Evaluation of volumetric measurements in patients with acute type B aortic dissection – thoracic endovascular aortic repair (TEVAR) vs conservative

“…This study included volumetric measurements and their correlation with the length of stent-graft-coverage and the number of re-entry points, but the focus was placed on clinical aspects. 19 The aim of the present retrospective study was to evaluate volume changes in patients with acute TBD, who underwent either TEVAR or conservative treatment, including volumetric measurements of the true thoracic lumen (TTL), the false thoracic lumen (FTL), the thoracic lumen (TL), and the abdominal lumen (AL) in both patient groups. In addition, thrombosis of the false lumen was assessed in both patient groups and the impact of thrombosis on aortic lumen changes was analyzed.…”

Volume changes in aortic true and false lumen after the “PETTICOAT” procedure for type B aortic dissection

“…Recent papers have evaluated, with CT volumetric analysis, the evolution of TL and FL after standard stent graft repair of aortic dissection. [7][8][9] Different authors stated that using diameter measurements is not sensitive and adequate to evaluate the behavior of aortic dissection due to the long extent of the aortic pathology. 18 On the other hand, volumetric measurements permit to assess morphologic changes induced by endovascular treatment providing valuable insight of aortic remodeling and have already been validated in other studies with intra-and interobserver variability of 5% to 10%.…”

“…Steingruber et al 7,8 demonstrated that standard stent graft endovascular repair of TBD could be useful to achieve stabilization of the aorta, in the stented segment, even during the midterm follow-up, with a TL volume increase, up to 124% at 1 year and 191% at 2 years, and nearly stable FL volume. The segment from the distal end of the stent graft to celiac artery, however, showed unstable TL and FL volumes, and the abdominal segment showed no significant differences before and after the treatment.…”

“…5,6 Actually, in spite of successful deployment of the standard stent graft over the proximal entry tear, the TL distal to the stent graft may fail to dilate satisfactorily. [7][8][9] It is possible to address this problem by deploying specifically designed bare stents distally to standard stent grafts. 10,11 In 2003, Ito et al 12 reported a case of TBD with malperfusion successfully treated with only implantation of Gianturco Z-stents in the distal thoracic and abdominal aorta.…”

Retrograde Type A Dissection After Endovascular Repair of a “zone 0” Nondissecting Aortic Arch Aneurysm

“…Also from the real world single-center experience, RTDA is emerging as mainly a fatal complication (Table I). [5][6][7][8][9][10][11][12][13] Although in the EuREC, only one case of RTAD was observed in ''zone 0'', here a number of potential mechanisms may be hypothesized not only generically related to the advancement of stiff guidewires and large sheaths in the thoracic aorta but also to the progression of the underlying aortic disease.…”