Five-Year Results of Aortic Remodeling for Acute, Subacute, and Chronic Type B Aortic Dissection Following Endovascular Repair
BackgroundThis study was performed to compare aortic remodeling and clinical outcomes in patients with acute, subacute, and chronic type B aortic dissection (TBAD) after thoracic endovascular aortic repair (TEVAR).MethodsWe retrospectively examined 323 consecutive patients with acute (n = 129), suba...
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Frontiers Media S.A.
2022-05-01
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| Series: | Frontiers in Cardiovascular Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2022.847368/full |
| _version_ | 1811235306577330176 |
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| author | Guangmin Yang Guangmin Yang Hongwei Ge Guangyan Wu Yepeng Zhang Leiyang Zhang Ming Zhang Xiaoqiang Li Min Zhou |
| author_facet | Guangmin Yang Guangmin Yang Hongwei Ge Guangyan Wu Yepeng Zhang Leiyang Zhang Ming Zhang Xiaoqiang Li Min Zhou |
| author_sort | Guangmin Yang |
| collection | DOAJ |
| description | BackgroundThis study was performed to compare aortic remodeling and clinical outcomes in patients with acute, subacute, and chronic type B aortic dissection (TBAD) after thoracic endovascular aortic repair (TEVAR).MethodsWe retrospectively examined 323 consecutive patients with acute (n = 129), subacute (n = 161), and chronic (n = 33) TBAD who underwent TEVAR from June 2013 to December 2016 in in multicenter institution. Patient demographics, clinical data, and imaging characteristics were recorded and compared among the three groups.ResultsThe three groups had comparable baseline characteristics. Perioperative mortality rates were similar among the acute (2.3%), subacute (0.0%), and chronic (0.0%) groups (P = 0.34). Perioperative morbidity rates, including the rates of visceral and lower limb malperfusion and cerebral infraction, were also similar. The rate of perioperative endoleak was significantly higher in the chronic group (18.1%) than in the acute (3.9%) and subacute (3.7%) groups (P = 0.02). The mean follow-up duration was 78 ± 22 months (range, 36–101 months). The mortality rates were comparable among the three groups. The rates of reintervention and lower limb malperfusion were higher in the chronic group than in the acute and subacute groups. FL diameter reduction were more robust in the acute and subacute groups than in the chronic group.ConclusionPatients with acute, subacute, and chronic TBAD had different outcomes in this study. Patients with acute and subacute TBAD had fewer complications than those with chronic TBAD. Aortic remodeling after TEVAR was more favorable in patients with acute and subacute TBAD than in patients with chronic TBAD. TEVAR promotes more positive remodeling at the stent graft level than at the distal level of the aorta. |
| first_indexed | 2024-04-12T11:48:38Z |
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| language | English |
| last_indexed | 2024-04-12T11:48:38Z |
| publishDate | 2022-05-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj.art-b5e4db11c8d34f04b5df64bbe56878932022-12-22T03:34:15ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2022-05-01910.3389/fcvm.2022.847368847368Five-Year Results of Aortic Remodeling for Acute, Subacute, and Chronic Type B Aortic Dissection Following Endovascular RepairGuangmin Yang0Guangmin Yang1Hongwei Ge2Guangyan Wu3Yepeng Zhang4Leiyang Zhang5Ming Zhang6Xiaoqiang Li7Min Zhou8Department of Vascular Surgery, Drum Tower Hospital, Affiliated to School of Medicine, Nanjing University, Nanjing, ChinaDepartment of Thoracic and Cardiovascular Surgery, Nanjing First Hospital, Nanjing Medical University, Nanjing, ChinaDepartment of Vascular Surgery, The Third Affiliated Hospital of Soochow University, Changzhou, ChinaDepartment of Vascular Surgery, Drum Tower Hospital, Affiliated to School of Medicine, Nanjing University, Nanjing, ChinaDepartment of Vascular Surgery, Drum Tower Hospital, Affiliated to School of Medicine, Nanjing University, Nanjing, ChinaDepartment of Thoracic and Cardiovascular Surgery, Nanjing First Hospital, Nanjing Medical University, Nanjing, ChinaDepartment of Vascular Surgery, Drum Tower Hospital, Affiliated to School of Medicine, Nanjing University, Nanjing, ChinaDepartment of Vascular Surgery, Drum Tower Hospital, Affiliated to School of Medicine, Nanjing University, Nanjing, ChinaDepartment of Vascular Surgery, Drum Tower Hospital, Affiliated to School of Medicine, Nanjing University, Nanjing, ChinaBackgroundThis study was performed to compare aortic remodeling and clinical outcomes in patients with acute, subacute, and chronic type B aortic dissection (TBAD) after thoracic endovascular aortic repair (TEVAR).MethodsWe retrospectively examined 323 consecutive patients with acute (n = 129), subacute (n = 161), and chronic (n = 33) TBAD who underwent TEVAR from June 2013 to December 2016 in in multicenter institution. Patient demographics, clinical data, and imaging characteristics were recorded and compared among the three groups.ResultsThe three groups had comparable baseline characteristics. Perioperative mortality rates were similar among the acute (2.3%), subacute (0.0%), and chronic (0.0%) groups (P = 0.34). Perioperative morbidity rates, including the rates of visceral and lower limb malperfusion and cerebral infraction, were also similar. The rate of perioperative endoleak was significantly higher in the chronic group (18.1%) than in the acute (3.9%) and subacute (3.7%) groups (P = 0.02). The mean follow-up duration was 78 ± 22 months (range, 36–101 months). The mortality rates were comparable among the three groups. The rates of reintervention and lower limb malperfusion were higher in the chronic group than in the acute and subacute groups. FL diameter reduction were more robust in the acute and subacute groups than in the chronic group.ConclusionPatients with acute, subacute, and chronic TBAD had different outcomes in this study. Patients with acute and subacute TBAD had fewer complications than those with chronic TBAD. Aortic remodeling after TEVAR was more favorable in patients with acute and subacute TBAD than in patients with chronic TBAD. TEVAR promotes more positive remodeling at the stent graft level than at the distal level of the aorta.https://www.frontiersin.org/articles/10.3389/fcvm.2022.847368/fullmulticenter-center retrospective cohort study type B aortic dissectionthoracic endovascular aortic repairaortic remodelingendoleaktype B aortic dissection |
| spellingShingle | Guangmin Yang Guangmin Yang Hongwei Ge Guangyan Wu Yepeng Zhang Leiyang Zhang Ming Zhang Xiaoqiang Li Min Zhou Five-Year Results of Aortic Remodeling for Acute, Subacute, and Chronic Type B Aortic Dissection Following Endovascular Repair Frontiers in Cardiovascular Medicine multicenter-center retrospective cohort study type B aortic dissection thoracic endovascular aortic repair aortic remodeling endoleak type B aortic dissection |
| title | Five-Year Results of Aortic Remodeling for Acute, Subacute, and Chronic Type B Aortic Dissection Following Endovascular Repair |
| title_full | Five-Year Results of Aortic Remodeling for Acute, Subacute, and Chronic Type B Aortic Dissection Following Endovascular Repair |
| title_fullStr | Five-Year Results of Aortic Remodeling for Acute, Subacute, and Chronic Type B Aortic Dissection Following Endovascular Repair |
| title_full_unstemmed | Five-Year Results of Aortic Remodeling for Acute, Subacute, and Chronic Type B Aortic Dissection Following Endovascular Repair |
| title_short | Five-Year Results of Aortic Remodeling for Acute, Subacute, and Chronic Type B Aortic Dissection Following Endovascular Repair |
| title_sort | five year results of aortic remodeling for acute subacute and chronic type b aortic dissection following endovascular repair |
| topic | multicenter-center retrospective cohort study type B aortic dissection thoracic endovascular aortic repair aortic remodeling endoleak type B aortic dissection |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2022.847368/full |
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