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Novel and Innovative Hybrid Technique for Type A Aortic Dissection
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Retrograde aortic dissection after thoracic endovascular aortic repair
Ludovic Canaud1, Baris A Ozdemir, Benjamin O Patterson
1From the Department of Outcomes Research, St George's Vascular Institute, London, United Kingdom.
Annals of Surgery
|January 21, 2014
Summary
Retrograde type A aortic dissection (RTAD) after thoracic endovascular aortic repair (TEVAR) is rare but deadly. It is linked to treating acute/chronic dissections and oversized devices.
Area of Science:
- Cardiovascular Surgery
- Endovascular Interventions
- Aortic Disease
Background:
- Thoracic endovascular aortic repair (TEVAR) is a common treatment for thoracic aortic pathologies.
- Complications following TEVAR can significantly impact patient outcomes.
- Retrograde type A aortic dissection (RTAD) is a rare but serious complication after TEVAR.
Purpose of the Study:
- To investigate the incidence, etiology, and timing of RTAD following TEVAR.
- To identify risk factors associated with RTAD after TEVAR.
- To analyze the outcomes and mortality associated with RTAD.
Main Methods:
- Data were collected from the MOTHER Registry and supplemented by a systematic literature review.
- Patient and technical factors were analyzed using univariate and binary logistic regression.
- Incidence and risk factors for RTAD were determined.
Main Results:
- RTAD occurred in 1.6% of patients in the MOTHER Registry and 1.7% overall.
- TEVAR for acute or chronic aortic dissection and device oversizing were significant risk factors for RTAD.
- RTAD most commonly occurred in the immediate postoperative period (58%) with a high mortality rate (33.6%).
Conclusions:
- RTAD is an uncommon but high-mortality complication after TEVAR.
- Treatment of acute and chronic type B aortic dissection and device oversizing increase RTAD risk.
- Proximal endograft configuration did not influence RTAD incidence.
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