Outcomes of Thoracic Endovascular Aortic Repair for Acute Type B Dissection in Patients With Intractable Pain or Refractory Hypertension

Laquian, Liza; Scali, Salvatore T.; Beaver, Thomas M.; Kubilis, Paul; Beck, Adam W.; Giles, Kristina A.; Huber, Thomas S.; Feezor, Robert J.

doi:10.1177/1526602818759339

Cited by 13 publications

(13 citation statements)

References 36 publications

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“…Procedures for repairing proximal aortic dissection have shown markedly improved survival rates in the acute phase. 14 Nevertheless, some of the distal intimal tears and false lumens persist without intervention, especially in the descending aorta 5 and abdominal aorta. 15 Most Stanford type A aortic dissections have a patent distal false lumen after open repair of the ascending aorta, with disease progression at a rate of 1 to 3.7 mm per year.…”

Section: Discussionmentioning

confidence: 99%

Total Endovascular Repair With Parallel Stent-Grafts for Postdissection Thoracoabdominal Aneurysm After Prior Proximal Repair

Liu

Feng

et al. 2019

J Endovasc Ther

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Purpose: To evaluate the safety and efficacy of total endovascular repair with parallel stent-grafts for postoperative residual dissection thoracoabdominal aortic aneurysm (TAAA). Materials and Methods: A retrospective study was undertaken of 21 patients (mean age 64.0±12.5 years; 17 men) undergoing total endovascular therapy with parallel stent-grafts for postdissection TAAA after prior proximal repair between 2014 and 2016. The preoperative minimum true lumen diameter was 12.3±4.8 mm and the mean extent of dissection was 248.1±48.2 mm. Pre-, intra-, and postoperative medical records were reviewed to assess technical success, spinal cord ischemia, patency of target branch arteries, endoleak, and short-term outcomes of this approach. Results: Technical success was achieved in 17 of 21 patients owing to 4 type I endoleaks at the end of the procedures. A total of 70 branch arteries were revascularized and 14 celiac trunks were covered intentionally without reconstruction. Of 7 intraoperative endoleaks, 2 were managed intraoperatively and 5 (4 type I and 1 type II) disappeared spontaneously within 1 month. No spinal cord or abdominal organ or limb ischemia was observed. Mean follow-up was 16.2±6.1 months. No death or type I or III endoleak occurred during the follow-up; 2 type II endoleaks were observed. Nineteen of the 21 false lumens thrombosed, and the total aortic diameter decreased (57.3±8.4 to 55.3±7.4 mm, p<0.01). Three (4.3%) of 70 target branch arteries occluded during follow-up. The cumulative patency of retrogradely and antegradely revascularized branch arteries was 97.3% vs 100% at 12 months and 91.2% vs 100% at 18 months. Conclusion: Total endovascular therapy with parallel stent-grafts could be an effective alternative in treating postdissection TAAA. Further studies with long-term follow-up and larger sample size are recommended to evaluate the technique.

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Section: Discussionmentioning

confidence: 99%

Total Endovascular Repair With Parallel Stent-Grafts for Postdissection Thoracoabdominal Aneurysm After Prior Proximal Repair

Liu

Feng

et al. 2019

J Endovasc Ther

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“…A recent study compared uncomplicated acute type B aortic dissections (UATBAD) with intractable pain or refractory hypertension which are treated with TEVAR or best medical therapy. The study showed that TEVAR was safe but did not offer a better short term outcome than the patients who are taking best medical therapy [14]. In our study group there were 2 patients with complicated acute type B dissection and one patient with a chronic type B dissection who have unthrombosed false lumen with progressive enlargement of diameter.…”

Section: Discussionmentioning

confidence: 71%

Evaluation of Early and Mid-term Results of TEVAR Procedures with Various Etiology.

Şenarslan

Yıldırım

Teti̇k

2019

Celal Bayar Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi

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“…RTAD is a complication with low incidence (2.5-8%) but high mortality rate (37.1-40%) after TEVAR. 3–5 Although some patients received successful thoracotomy, multiple organ dysfunction syndrome and death are prevalent in the postoperative period. 6…”

Section: Discussionmentioning

confidence: 99%

Generalized convulsive status epilepticus after retrograde type A aortic dissection surgery

Shi

et al. 2020

Perfusion

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Introduction: Generalized convulsive status epilepticus is defined as a generalized and convulsive seizure with 5 minutes or more of continuous clinical and/or electrographic seizure activity or recurrent seizure activity without recovery between seizures. For the first time, we present a case with retrograde type A aortic dissection after endovascular repairment and received thoracotomy intensely. Case report: The patient experienced frequent generalized seizures in the immediate postoperative period, and status epilepticus was considered for his medical history, clinic symptoms and related examinations. Discussion and Conclusion: Generalized convulsive status epilepticus should be alert for avoiding delay in the rehabilitation particularly after aortic dissection surgery. Under the good condition of ventilation, combining morphine with midazolam or diazepam can more effectively relieve the symptoms.

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Outcomes of Thoracic Endovascular Aortic Repair for Acute Type B Dissection in Patients With Intractable Pain or Refractory Hypertension

Cited by 13 publications

References 36 publications

Total Endovascular Repair With Parallel Stent-Grafts for Postdissection Thoracoabdominal Aneurysm After Prior Proximal Repair

Total Endovascular Repair With Parallel Stent-Grafts for Postdissection Thoracoabdominal Aneurysm After Prior Proximal Repair

Evaluation of Early and Mid-term Results of TEVAR Procedures with Various Etiology.

Generalized convulsive status epilepticus after retrograde type A aortic dissection surgery

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