Mid-Term Outcomes of Acute Type B Aortic Dissection in Japan Single Center

Abstract

Purpose: To study mid-term outcomes in patients admitted to receive treatment for acute type B aortic dissection. Methods: The study group comprised 229 patients with acute type B aortic dissection treated between January 2000 and July 2010. 128 patients had a thrombosed false lumen, and 101 had a patent false lumen. Results: In the thrombosed group, 6 had rupture, 4 had malperfusion, and 118 had no complications. There were 5 early deaths (3.9%). In the patent group, 12 had rupture, 19 had malperfusion, and 70 had no complications. There were 6 early deaths (5.9%). Overall survival rates in the thrombosed group and the patent group were 94.7 ± 2.2% and 90.2 ± 3.2% at 1 year, and 84.3 ± 4.6% and 85.9 ± 4.3% at 5 years (p = 0.892), respectively. Aorta-related event-free rates were 85.6 ± 3.4% and 48.3 ± 5.5% at 1 year, and 76.0 ± 5.1% and 35.2 ± 7.2% at 5 years (p <0.001), respectively. Conclusions: The incidences of rupture and malperfusion during the acute phase were higher in the patent group compared with the thrombosed group. At the late period, although the aorta-related event rate was higher in the patent group, the survival rate did not differ between two groups. Close follow-up and aggressive intervention strategy of the patent group may result comparable outcomes with the thrombosed group.

TEVAR for complicated and uncomplicated type B aortic dissection—Systematic review and meta‐analysis

“…The total number of patients included in the analysis was 16,104 and data was extracted from 89 studies 4–92 . Among them, 7772 patients were categorized as co‐TBAD and 8352 as un‐TBAD.…”

Emergency thoracic aortic stent grafting for acute complicated type B aortic dissection after a previous abdominal endovascular aneurysm repair

“…Entry closure by a stent graft can be effective; however, the preventive benefit of an aneurysm rupture remains unclear. After treatment of TEVAR, approximately 25 % of the patients require reintervention due to endoleaks and increasing false lumens in size [7–9]. Furthermore, a ruptured false lumen was found to be an independent risk factor for the long-term survival [10].…”

Early Detection of Vulnerable Atherosclerotic Plaque for Risk Reduction of Acute Aortic Rupture and Thromboemboli and Atheroemboli Using Non-Obstructive Angioscopy

“…17 Reported survival rates of aortic dissection have ranged from 52% to 94% at 1 year and from 45% to 88% at 5 years. 25 Thus, pre-emptive medicine is therefore important to prevent ruptured aortic aneurysm and dissection regardless of improvements in the outcomes of surgery and EVAR.…”