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Midterm results for endovascular repair of complicated acute and chronic type B aortic dissection.

Publication ,  Journal Article
Parsa, CJ; Schroder, JN; Daneshmand, MA; McCann, RL; Hughes, GC
Published in: Ann Thorac Surg
January 2010

BACKGROUND: Thoracic endovascular aortic repair (TEVAR) for the management of type B aortic dissections has become more commonplace despite some controversy. Results of endovascular management of complicated acute (<2 weeks from symptom onset) and chronic (>2 weeks) type B aortic dissection with a view towards determining safety, efficacy, and requirement for secondary procedures are reviewed. METHODS: Between June 2005 and November 2008, 55 patients (41 men) with a mean age of 59 +/- 12 years (range, 31 to 77 years) underwent TEVAR for the management of complicated acute (n = 22) or chronic (n = 33) type B dissection. Indications in acute dissection included impending or frank rupture in 11 and malperfusion syndromes in 11; the indication in chronic dissections was aneurysmal degeneration in 33. RESULTS: Primary technical success was 100%. In-hospital and 30-day rates of death, stroke, and permanent paraplegia/paresis were 2% (n = 1), 0%, and 2% (n = 1), respectively. Median follow-up was 7.1 months (range, 1 to 38 months). Overall actuarial midterm survival was 63% at 38 months, with an aorta-specific actuarial survival of 94%. Two patients (4%) required late conversion to open repair. Postoperative type I or III endoleak occurred in 3 (6%) and type II endoleak in 7 (15%). Two patients underwent subsequent endovascular occlusion. The composite reintervention rate in follow-up was 23.4% (n = 13). CONCLUSIONS: Endovascular repair for complicated acute and chronic type B dissection is safe and effective at early midterm follow-up. TEVAR for type B dissection requires more secondary interventions and imaging surveillance than conventional open reconstruction. Longer-term follow-up is needed to determine the durability of this approach.

Duke Scholars

Published In

Ann Thorac Surg

DOI

EISSN

1552-6259

Publication Date

January 2010

Volume

89

Issue

1

Start / End Page

97 / 102

Location

Netherlands

Related Subject Headings

  • Vascular Surgical Procedures
  • United States
  • Treatment Outcome
  • Tomography, X-Ray Computed
  • Time Factors
  • Survival Rate
  • Severity of Illness Index
  • Retrospective Studies
  • Respiratory System
  • Middle Aged
 

Citation

APA
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ICMJE
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Parsa, C. J., Schroder, J. N., Daneshmand, M. A., McCann, R. L., & Hughes, G. C. (2010). Midterm results for endovascular repair of complicated acute and chronic type B aortic dissection. Ann Thorac Surg, 89(1), 97–102. https://doi.org/10.1016/j.athoracsur.2009.09.029
Parsa, Cyrus J., Jacob N. Schroder, Mani A. Daneshmand, Richard L. McCann, and G Chad Hughes. “Midterm results for endovascular repair of complicated acute and chronic type B aortic dissection.Ann Thorac Surg 89, no. 1 (January 2010): 97–102. https://doi.org/10.1016/j.athoracsur.2009.09.029.
Parsa CJ, Schroder JN, Daneshmand MA, McCann RL, Hughes GC. Midterm results for endovascular repair of complicated acute and chronic type B aortic dissection. Ann Thorac Surg. 2010 Jan;89(1):97–102.
Parsa, Cyrus J., et al. “Midterm results for endovascular repair of complicated acute and chronic type B aortic dissection.Ann Thorac Surg, vol. 89, no. 1, Jan. 2010, pp. 97–102. Pubmed, doi:10.1016/j.athoracsur.2009.09.029.
Parsa CJ, Schroder JN, Daneshmand MA, McCann RL, Hughes GC. Midterm results for endovascular repair of complicated acute and chronic type B aortic dissection. Ann Thorac Surg. 2010 Jan;89(1):97–102.
Journal cover image

Published In

Ann Thorac Surg

DOI

EISSN

1552-6259

Publication Date

January 2010

Volume

89

Issue

1

Start / End Page

97 / 102

Location

Netherlands

Related Subject Headings

  • Vascular Surgical Procedures
  • United States
  • Treatment Outcome
  • Tomography, X-Ray Computed
  • Time Factors
  • Survival Rate
  • Severity of Illness Index
  • Retrospective Studies
  • Respiratory System
  • Middle Aged