The Impact of Thoracic Endovascular Aortic Repair on Long-Term Survival in Type B Aortic Dissection

Lou, Xiaoying; Chen, Edward P.; Duwayri, Yazan; Veeraswamy, Ravi K.; Jordan, William D.; Zehner, Carl A.; Leshnower, Bradley G.

doi:10.1016/j.athoracsur.2017.06.016

Cited by 68 publications

(51 citation statements)

References 26 publications

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“…The presented data compare favorably with the mortality rates reported by other recent studies. 11,12,[14][15][16][17] The 2-year overall survival rate was 93% for those with acute uncomplicated TBAD and 83% for those with all other categories of TBAD. The unifying feature of the patients with a statistically significant decrease in their freedom from all-cause mortality (acute complicated TBAD, chronic complicated TBAD, and chronic uncomplicated TBAD) presumably resulted from the presence of a complicated presentation, because most physicians would not treat a truly uncomplicated chronic dissection.…”

Section: Discussionmentioning

confidence: 98%

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Outcomes from the Gore Global Registry for Endovascular Aortic Treatment in patients undergoing thoracic endovascular aortic repair for type B dissection

Tjaden

Sandhu

Miller

et al. 2018

Journal of Vascular Surgery

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TEVAR for TBAD using the conformable GORE TAG thoracic endoprosthesis device can be performed with a low incidence of aortic mortality and complications. Acute uncomplicated TBAD patients had a significantly lower mortality rate than that of other patients. Larger proximal landing zones were associated with more frequent retrograde type A dissection. LSA involvement (coverage and/or revascularization) was associated with an increased risk of AEs during follow-up.

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Section: Discussionmentioning

confidence: 98%

“…Stroke and SCI occurred at lower rates than recently reported. [10][11][12] The most common AE was endoleak. However, the presence of an endoleak was not associated with a decrease in survival.…”

Section: Discussionmentioning

confidence: 99%

Outcomes from the Gore Global Registry for Endovascular Aortic Treatment in patients undergoing thoracic endovascular aortic repair for type B dissection

Tjaden

Sandhu

Miller

et al. 2018

Journal of Vascular Surgery

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“…The introduction of TEVAR revolutionized the treatment of TBAD with aneurysmal degeneration, but false lumen patency remains a problem and often requires reintervention to prevent late aortic rupture and death. [6][7][8] Dongze and Cao 13 reported a hazard ratio of 2.79 in TEVAR treatment of TBAD with residual false lumen patency. Patent false lumens confer a fivefold increased risk of any aortic event compared with thrombosed false lumens.…”

Section: Discussionmentioning

confidence: 99%

“…5,6 As many as 15% to 30% of patients undergoing TEVAR require reintervention. [6][7][8] Approximately 20% of these patients require reintervention because of false lumen perfusion and increasing aortic growth and degeneration. 6,9,10 Lack of false lumen thrombosis and aortic remodeling after TEVAR can increase late mortality.…”

mentioning

confidence: 99%

False lumen embolization as a rescue technique in the setting of acute and chronic dissecting aneurysms as adjunct to thoracic endovascular aortic repair

Rakestraw

Feghali

Nguyen

et al. 2020

Journal of Vascular Surgery Cases, Innovations and Techniques

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Complicated type B aortic dissection (TBAD) is a life-threatening condition requiring surgical intervention. One such complication in the acute or chronic setting is aneurysmal degeneration. The dissected aortic wall is weakened, and the pressures in the false lumen are often high. In the past decade, thoracic endovascular aortic repair (TEVAR) has become the treatment of choice for TBAD. TEVAR can be complicated by lack of false lumen thrombosis, increasing the risk of death. We present three cases of TBAD with patent false lumens after TEVAR that were treated by false lumen coil embolization. (J Vasc Surg Cases and Innovative Techniques 2020;6:110-7.)

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“…A recent review concluded that the long-term results of BMT alone for the treatment of uncomplicated type B dissection were inferior to those of the complicated type and showed a high frequency of surgical intervention. 49 Based on these evidences, TEVAR for acute TBAD is listed as the first-line treatment option in the ESVS guidelines. 21 Chronic TBAD, including a residual dissection after repair of an acute type A dissection, is defined as "chronic" when 2 weeks have elapsed from the onset.…”

Section: Acute and Chronic Type B Dissectionmentioning

confidence: 99%

Endovascular Treatment of Various Aortic Pathologies: Review of the Latest Data and Technologies

2018

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The technologies and innovations applicable to endovascular treatment for complex aortic pathologies have progressed rapidly over the last two decades. Although the initial outcomes of an endovascular aortic repair have been excellent, as long-term data became available, complications including endoleaks, endograft migration, and endograft infection have become apparent and are of concern. Previously, the indication for endovascular therapy was restricted to descending thoracic aortic aneurysms and abdominal aortic aneurysms. However, its indication has expanded along with the improvement of techniques and devices, and currently, it has become possible to treat pararenal aortic aneurysms and Crawford type 4 thoracoabdominal aortic aneurysm (TAAA) using the off-the-shelf devices. Additionally, custom-made devices allow for the treatment of arch or more extensive TAAAs. Endovascular treatment is applied not only to aneurysms but also to acute/chronic dissections. However, long-term outcomes are still unclear. This article provides an overview of available devices and the results of endovascular treatment for various aortic pathologies.

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The Impact of Thoracic Endovascular Aortic Repair on Long-Term Survival in Type B Aortic Dissection

Cited by 68 publications

References 26 publications

Outcomes from the Gore Global Registry for Endovascular Aortic Treatment in patients undergoing thoracic endovascular aortic repair for type B dissection

Outcomes from the Gore Global Registry for Endovascular Aortic Treatment in patients undergoing thoracic endovascular aortic repair for type B dissection

False lumen embolization as a rescue technique in the setting of acute and chronic dissecting aneurysms as adjunct to thoracic endovascular aortic repair

Endovascular Treatment of Various Aortic Pathologies: Review of the Latest Data and Technologies

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