Updates on Indications for TEVAR in Type B Aortic Dissection

Malaisrie, S. Chris; Mehta, Christopher K.

doi:10.1177/1556984520961037

Cited by 13 publications

(15 citation statements)

References 55 publications

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“…The surgical success rate of TEVAR in acute or chronic TBAD is 99.1%, and in-hospital mortality rates are 1.6%, with good long-term efficacy [ 8 ]. TEVAR has been shown to improve the survival rate in the treatment of uncomplicated Stanford B aortic dissection, but it may still cause complications, and its safety is still in question [ 9 , 10 ].…”

Section: Introductionmentioning

confidence: 99%

Endovascular Repair of the Thoracic Aorta Combined with Drug Therapy in Acute Uncomplicated Type B Aortic Dissection

Meng

Qin

2022

Disease Markers

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Objective. This study was to evaluate the clinical efficacy of thoracic endovascular aortic repair (TEVAR) combined with Best Medical Therapy (BMT) in acute uncomplicated type B aortic dissection (TBAD). Methods. Using the random method, 90 patients admitted to our hospital between January 2018 and January 2020 with acute uncomplicated TBAD were randomly divided into a control group and a study group, with 45 cases in each of the groups. The effectiveness of BMT combined with TEVAR treatment was compared. Results. The incidence of recent adverse reactions did not differ significantly between the two groups. Compared to the control group, the 1-year survival rate and 2-year survival rate of patients in the study group were considerably higher. In order to examine the relationship between survival and time, the Kaplan-Meier curve was used. Both groups reached the median survival time after 24 months of follow-up. The expected survival time of the study group was longer than that of the control group. False lumen thrombosis or absence of thrombus was significantly more prevalent in the study group than in the control group. Conclusion. For patients with acute uncomplicated TBAD, BMT combined with TEVAR can significantly improve the long-term survival rate and increase the expected survival time.

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Section: Introductionmentioning

confidence: 99%

Endovascular Repair of the Thoracic Aorta Combined with Drug Therapy in Acute Uncomplicated Type B Aortic Dissection

Meng

Qin

2022

Disease Markers

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“…Two life-threatening complications that arise from acute TBAD are rupture and malperfusion. 8 Rupture with extravasation outside the adventitia of the aorta manifests as a hemothorax or a periaortic or mediastinal hematoma. 3 Malperfusion is the most common indication for emergency intervention and is the result of inadequate blood flow to a tissue bed (cerebral, renal, visceral, iliofemoral, or spinal cord).…”

Section: Presence Of Complicationsmentioning

confidence: 99%

“…3 Malperfusion is the most common indication for emergency intervention and is the result of inadequate blood flow to a tissue bed (cerebral, renal, visceral, iliofemoral, or spinal cord). 8 It is further characterized by dynamic or static mechanisms. Dynamic malperfusion occurs when, during the cardiac cycle, changes in blood flow and pressure between the true and false lumens cause intermittent obstruction of a branch vessel by the mobile dissection flap of the vessel's orifice.…”

Section: Presence Of Complicationsmentioning

confidence: 99%

Medical or endovascular management of acute type B aortic dissection

Hong

Huu

Preventza

2022

The Journal of Thoracic and Cardiovascular Surgery

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“…KINETIC ENERGY. Voxel-wise KE was defined by: 2 where ρ is the assumed blood density of 1060 kg/m 3 , dV is the unit voxel volume (ie, 1 mm 3 ) and v(t) is the velocity magnitude for each voxel at each cardiac time-frame.…”

Section: Parametric Hemodynamic Mapsmentioning

confidence: 99%

Hemodynamic Evaluation of Type B Aortic Dissection Using Compressed Sensing Accelerated 4D Flow MRI

Kilinç

Chu

Baraboo

et al. 2022

Magnetic Resonance Imaging

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Background 4D Flow MRI is a quantitative imaging technique to evaluate blood flow patterns; however, it is unclear how compressed sensing (CS) acceleration would impact aortic hemodynamic quantification in type B aortic dissection (TBAD). Purpose To investigate CS‐accelerated 4D Flow MRI performance compared to GRAPP‐accelerated 4D Flow MRI (GRAPPA) to evaluate aortic hemodynamics in TBAD. Study Type Prospective. Population Twelve TBAD patients, two volunteers. Field Strength/Sequence 1.5T, 3D time‐resolved cine phase‐contrast gradient echo sequence. Assessment GRAPPA (acceleration factor [R] = 2) and two CS‐accelerated (R = 7.7 [CS7.7] and 10.2 [CS10.2]) 4D Flow MRI scans were acquired twice for interscan reproducibility assessment. Voxelwise kinetic energy (KE), peak velocity (PV), forward flow (FF), reverse flow (RF), and stasis were calculated. Plane‐based mid‐lumen flows were quantified. Imaging times were recorded. Tests Repeated measures analysis of variance, Pearson correlation coefficients (r), intraclass correlation coefficients (ICC). P < 0.05 indicated statistical significance. Results The KE and FF in true lumen (TL) and PV in false lumen (FL) did not show difference among three acquisition types (P = 0.818, 0.065, 0.284 respectively). The PV and stasis in TL were higher, KE, FF, and RF in FL were lower, and stasis was higher in GRAPPA compared to CS7.7 and CS10.2. The RF was lower in GRAPPA compared to CS10.2. The correlation coefficients were strong in TL (r = [0.781–0.986]), and low to strong in FL (r = [0.347–0.948]). The ICC levels demonstrated moderate to excellent interscan reproducibility (0.732–0.989). The FF and net flow in mid‐descending aorta TL were significantly different between CS7.7 and CS10.2. Conclusion CS‐accelerated 4D Flow MRI has potential for clinical utilization with shorter scan times in TBAD. Our results suggest similar hemodynamic trends between acceleration types, but CS‐acceleration impacts KE, FF, RF, and stasis more in FL. Evidence Level: 1 Technical Efficacy: Stage 2

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Updates on Indications for TEVAR in Type B Aortic Dissection

Cited by 13 publications

References 55 publications

Endovascular Repair of the Thoracic Aorta Combined with Drug Therapy in Acute Uncomplicated Type B Aortic Dissection

Endovascular Repair of the Thoracic Aorta Combined with Drug Therapy in Acute Uncomplicated Type B Aortic Dissection

Medical or endovascular management of acute type B aortic dissection

Hemodynamic Evaluation of Type B Aortic Dissection Using Compressed Sensing Accelerated 4D Flow MRI

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