Aortic remodeling after thoracic endovascular aortic repair for intramural hematoma

Lavingia, Kedar S.; Ahanchi, Sadaf S.; Redlinger, Richard E.; Udgiri, Navalkishor; Panneton, Jean M.

doi:10.1016/j.jvs.2014.04.015

Cited by 31 publications

(21 citation statements)

References 22 publications

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“…This mechanism may contribute to ideal remodeling of the affected aorta. In fact, Lavingia et al 37 demonstrated excellent results after 44 endovascular stent grafting for IMH B. At a mean radiological follow-up of 13 months, the average thickness of the IMH decreases to 4 mm (P ¼ 0.01, vs. preoperative of 12 mm).…”

Section: Discussionmentioning

confidence: 97%

Midterm Results of Type B Intramural Hematoma Endovascular Treatment

Felisaz¹,

Dufranc²,

Heyndrickx³

et al. 2015

Annals of Vascular Surgery

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Section: Discussionmentioning

confidence: 97%

Midterm Results of Type B Intramural Hematoma Endovascular Treatment

Felisaz¹,

Dufranc²,

Heyndrickx³

et al. 2015

Annals of Vascular Surgery

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“…The proximal landing zone of the stent graft in the ruptured thoracic aortic aneurysm group was located near the aortic arch and was shorter and more curved than in the ruptured intramural hematoma group. The rupture sites in intramural hematomas are usually located in the straight descending thoracic aorta [22,23]. Therefore, a short, curved proximal landing zone might be related to endoleaks in ruptured thoracic aortic aneurysms.…”

Section: Discussionmentioning

confidence: 99%

Clinical outcomes of endovascular treatment for ruptured thoracic aortic disease

Choi¹,

Lee

Park

et al. 2021

Korean J Intern Med

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Background/Aims: Untreated rupture of the thoracic aorta is associated with a high mortality rate. We aimed to review the clinical results of endovascular treatment for ruptured thoracic aortic disease. Methods: We retrospectively reviewed data on 37 patients (mean age, 67.0 ± 15.18 years) treated for ruptured thoracic aortic disease from January 2005 to May 2016. The median follow-up duration was 308 days (interquartile range, 61 to 1,036.5). The primary end-point of the study was the composite of death, secondary intervention, endoleak, and major stroke/paraplegia after endovascular treatment. Results: The etiologies of ruptured thoracic aortic disease were aortic dissection (n = 11, 29.7%), intramural hematoma (n = 7, 18.9%), thoracic aortic aneurysm (n = 14, 37.8%), and traumatic aortic transection (n = 5, 13.5%). Three patients died within 24 hours of thoracic endovascular aortic repair, and one showed type I endoleak. The technical success rate was 89.2% (33/37). The in-hospital mortality rate was 13.5% (5/37); no deaths occurred during follow-up. The composite outcome rate during follow-up was 37.8% (14/37), comprising death (n = 5, 13.5%), secondary intervention (n = 5, 13.5%), endoleak (n = 5, 13.5%), and major stroke/paraplegia (n = 3, 8.1%). Left subclavian artery revascularization and proximal landing zone were not associated with the composite outcome. Low mean arterial pressure (MAP; ≤ 60 mmHg, [hazard ratio, 13.018; 95% confidence interval, 2.435 to 69.583, p = 0.003]) was the most significant predictor and high transfusion requirement in the first 24 hours was associated with event-free survival (log rank p = 0.018). Conclusions: Endovascular treatment achieves high technical success rates and acceptable clinical outcome. High transfusion volume and low MAP were associated with poor clinical outcomes.

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“…All patients with IMH should receive initial medical therapy to control pain and blood pressure (level I, grade C) (36). TEVAR is safe and effective in treating IMH and also contributes to ideal remodeling of the affected aorta (60,61).…”

Section: Treatment: Medical Treatment or Surgical Intervention Open mentioning

confidence: 99%

Aortic intramural hemorrhage: A distinct disease entity with mystery

Fei

et al. 2017

IRDR

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Aortic remodeling after thoracic endovascular aortic repair for intramural hematoma

Abstract: TEVAR is safe and effective in treating IMH and based on longitudinal computed tomography scan analysis, aortic remodeling is evidenced by normalization of all measured indices.

Cited by 31 publications

References 22 publications

Midterm Results of Type B Intramural Hematoma Endovascular Treatment

Midterm Results of Type B Intramural Hematoma Endovascular Treatment

Clinical outcomes of endovascular treatment for ruptured thoracic aortic disease

Aortic intramural hemorrhage: A distinct disease entity with mystery

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