Features of aortic remodeling in Stanford type B subacute aortic dissection after thoracic endovascular aortic repair and the influential factors
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R654.3

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    Abstract:

    Objective: To investigate the features of aortic remodeling in Stanford type B subacute aortic dissection after thoracic endovascular aortic repair (TEVAR) and the influential factors. Methods: The pre- and postoperative clinical and imaging data of 50 patients with Stanford type B sub-acute aortic dissection undergoing TEVAR in Department of Vascular Surgery of Anhui Provincial Hospital from January 2008 to June 2016 were retrospectively analyzed. The changes in the true lumen and false lumen of different segments of the aorta at postoperative 3, 6 and 12 months after TEVAR as well as the influential factors for postoperative aortic remodeling were analyzed. Results: The technical success rate of TEVAR was 100%. Eight patients were lost to follow-up after operation. The imaging data of the remaining 42 patients showed that at each time point after TEVAR, true lumen diameter was significantly increased and the false lumen diameter was significantly decreased compared with their preoperative values in the segment of the thoracic aorta (all P<0.05), while no significant changes were observed in both true lumen and false lumen of the abdominal aortic segment compared with their preoperative values (all P>0.05); the complete false lumen thrombosis rate of the thoracic aorta was higher than that of the abdominal aorta. Multivariate analysis showed that branches perfused from the false lumen (OR=27.45, P<0.05) and the presence of multiple tears (OR=19.02, P<0.05) were independent risk factors for adverse aortic remodeling in Stanford type B subacute aortic dissection after TEVAR. Conclusion: The aortic remodeling in the thoracic aorta is better than that in the abdominal aortic segment. The branches perfused from the false lumen and presence of multiple tears are independent risk factors for adverse aortic remodeling after TEVAR.

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RAO Congliang, HU Hejie, WANG Xiaotian, FANG Zhengdong, SUN Xiaojie, GE Xinbao,. Features of aortic remodeling in Stanford type B subacute aortic dissection after thoracic endovascular aortic repair and the influential factors[J]. Chin J Gen Surg,2017,26(12):1547-1554.
DOI:10.3978/j. issn.1005-6947.2017.12.007

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History
  • Received:September 06,2017
  • Revised:November 06,2017
  • Adopted:
  • Online: December 15,2017
  • Published: