Five-year results for endovascular repair of acute complicated type B aortic dissection

Abstract

This study confirms the excellent short-term outcomes of TEVAR for acute complicated type B dissection and demonstrates the results to be durable and sustained over long-term follow-up. Although aortic reinterventions were required in one-quarter of patients, no aortic-related deaths were observed. These data support the use of TEVAR for acute complicated type B aortic dissection but also highlight the importance of life-long aortic surveillance by an experienced aortic referral center in order to identify and treat complications of the underlying disease process and treatment, as well as new aortic pathologies, as they arise.

The Potential of Computational Fluid Dynamics Simulation on Serial Monitoring of Hemodynamic Change in Type B Aortic Dissection

“…With an aim to seal off the proximal primary entry tear, to promote false lumen thrombosis and aortic remodeling, thoracic endovascular aortic repair (TEVAR) as a treatment for acute complicated type B dissection is associated with reasonably good short-term and long-term clinical outcomes [1][2][3]. However, post-TEVAR complications including death from aortic rupture or retrograde type A dissection occur in up to 20 % and remain a major concern [2,4,5], and these complications are associated with persistent perfusion of the false lumen [6,7].…”

A Case of Re-Endovascular Repair in Acute Phase after Endovascular Aortic Repair for Acute Type B Aortic Dissection Complicated by Visceral, Renal and Lower Limb Malperfusion

“…In Jennifer's experience, 13 patients (26%) required reinterventions, but no patients required treatment for re-malperfusion in acute phase [13]. Though we did not observe stent malposition, stent migration or stent induced new entry reintervention was required at 2 days after the initial operation in our case.…”

New Paradigms in the Treatment of Acute Complicated and Uncomplicated Type B Aortic Dissection

“…The reintervention rate was substantial at 26%, but no deaths were attributable to aortic pathology in this series. 20 These studies, along with additional registry evidence, led the U.S. Food and Drug Administration to approve two endovascular devices for the management of type B dissection in 2014, and many physicians now consider TEVAR to be the optimal choice for the management of acute type B aortic dissection. 21 It should be noted, however, that despite this early excitement, long-term data is limited and TEVAR is not without complications such as paralysis, retrograde type A dissection, rupture and technical limitations.…”