Midterm Results of Thoracic Endovascular Aortic Repair in Patients With Aneurysms Involving the Descending Aorta Originating From Chronic Type B Dissections

Czerny, Martin; Roedler, Suzanne; Fakhimi, Setareh; Sodeck, Gottfried; Funovics, Martin; Dumfarth, Julia; Holfeld, Johannes; Schoder, Maria; Juraszek, Andrzej; Dziodzio, Tomasz; Zimpfer, Daniel; Krähenbühl, Eva; Rosenhek, Raphaël; Grimm, Michael

doi:10.1016/j.athoracsur.2010.04.001

Cited by 47 publications

(26 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In regard to these early and midterm complications, patient selection criteria (eg, anatomic considerations/timing of the procedure/amount of re-entries) for a successful, durable TEVAR procedure and the ultimate role of TEVAR in patients with CEAD have yet to be defined. 5,6,[17][18][19][20] In our perspective, the present issue in patients with CEAD is to identify patients most prone to reintervention and to compare long-term outcome in patients who underwent stent grafting. Despite the fact of missing data on controlled efficacy, stent grafting is an alternative option for high-risk surgical candidates with chronic aortic dissection.…”

Section: Discussionmentioning

confidence: 99%

Reinterventions during midterm follow-up after endovascular treatment of thoracic aortic disease

Geisbüsch

Hoffmann

Kotelis

et al. 2011

Journal of Vascular Surgery

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

Reinterventions during midterm follow-up after endovascular treatment of thoracic aortic disease

Geisbüsch

Hoffmann

Kotelis

et al. 2011

Journal of Vascular Surgery

View full text Add to dashboard Cite

show abstract

“…[64][65][66] However, this process is continuous, being completed in 6 to 12 months in most cases. 53,67,68 For chronic TBAD, more extended coverage of the descending aorta is associated with a higher incidence of FL thrombosis 69 and beneficial reduction in aortic volume, 67 although it is also a risk factor for spinal cord ischemia. 40,48,70 Another positive predictor of FL thrombosis seems to be the rate of TL expansion after TEVAR.…”

Section: In Vivo Biomechanical Changes After Tevar For Tbadmentioning

confidence: 99%

Biomechanical Changes After Thoracic Endovascular Aortic Repair in Type B Dissection

et al. 2015

View full text Add to dashboard Cite

Thoracic endovascular aortic repair (TEVAR) has evolved into an established treatment option for type B aortic dissection (TBAD) since it was first introduced 2 decades ago. Morbidity and mortality have decreased due to the minimally invasive character of TEVAR, with adequate stabilization of the dissection, restoration of true lumen perfusion, and subsequent positive aortic remodeling. However, several studies have reported severe setbacks of this technique. Indeed, little is known about the biomechanical behavior of implanted thoracic stent-grafts and the impact on the vascular system. This study sought to systematically review the performance and behavior of implanted thoracic stent-grafts and related biomechanical aortic changes in TBAD patients in order to update current knowledge and future perspectives.

show abstract

“…Recent data on endovascular repair of chronic complicated TBAD reveal excellent procedural and survival outcomes, but at the expense of further re-interventions. The rates of stroke following endovascular-based repair ranged between 0% to 5%, it was 0% to 2% for paraplegia, up to 14% procedure-related mortality (20)(21)(22)(23)(24)(25)58,60,(63)(64)(65)(66)(67)(68)(69)(70)(71)(72)(73)(74) (Table 7).…”

Section: Medical Managementmentioning

confidence: 99%

Conservative management versus endovascular or open surgery in the spectrum of type B aortic dissection

Yuan¹,

Mitsis²,

Ghonem³

et al. 2018

J. Vis. Surg.

View full text Add to dashboard Cite

Background: Type B aortic dissection is a life-threatening acute aortic condition often with acute ischemic signs or symptoms. With initial management focusing on alleviating malperfusion and pain, and avoiding propagation of dissection or rupture both systolic blood and pulse pressure should be reduced initially by an aggressive medical approach. In the setting of persistent signs of complications endovascular strategies have replaced open surgery and led to a fourfold increase in early survival and better long-term outcomes. Results: Our manuscript has summarized data collected over 12 years on management specific outcomes in the setting of distal aortic dissection and provides an up-to-date interpretation of the published evidence.For complicated cases, treated acutely, the 30-day or in-hospital mortality was 7.3% when managed by endovascular means, whereas the pooled rate for 30-day or in-hospital mortality was 19.0% when subjected to open repair. For acute uncomplicated type B dissection usually treated with blood pressure lowering medications, the pooled 30-day or in-hospital mortality rate was 2.4%. Survival rates at 5 years averaged at 60% (40% mortality). Freedom from any aortic event ranged from 34.0% to 83.9%, underlining an inherent risk of progression and late complications. For chronic complicated type B dissection, the rates of stroke, paraplegia and operative mortality following endovascular repair ranged from 5% to 13%, 2% to 13% and 2 to 13%, respectively, while 5-year survival rates after open repair ranged from 60% to 90%. In chronic uncomplicated type B dissection almost 90% of patients survive initial hospitalization and were subjected to medical management with a 5-year survival of 50-80%. However, up to 20-55% of medically treated patients develop aneurysmal degeneration after 5 years with an unknown risk of rupture.Conclusions: Currently, the less invasive strategy of endovascular repair (as compared to open surgery) provides improved 30-day or in-hospital survival in the setting of complicated acute type B aortic dissection and may seek broad application. Open surgical aortic reconstruction should be left to experienced aortic centres if endovascular management is not an option.

show abstract

Midterm Results of Thoracic Endovascular Aortic Repair in Patients With Aneurysms Involving the Descending Aorta Originating From Chronic Type B Dissections

Cited by 47 publications

References 11 publications

Reinterventions during midterm follow-up after endovascular treatment of thoracic aortic disease

Reinterventions during midterm follow-up after endovascular treatment of thoracic aortic disease

Biomechanical Changes After Thoracic Endovascular Aortic Repair in Type B Dissection

Conservative management versus endovascular or open surgery in the spectrum of type B aortic dissection

Contact Info

Product

Resources

About