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Aneurysmal Degeneration in Patients with Type B Aortic Dissection
Mohsen Bannazadeh1, Adewunmi Adeyemo1, Yolanda Munoz1
1Division of Vascular Surgery, Department of Surgery, William Beaumont Hospital, Royal Oak, MI.
Annals of Vascular Surgery
|July 17, 2016
Summary
Medical therapy is the primary treatment for type B aortic dissection (TBAD) with low complications. Surgical interventions are reserved for specific cases, offering comparable survival rates to medical management for TBAD.
Area of Science:
- Cardiovascular Surgery
- Vascular Surgery
- Thoracic Surgery
Background:
- Management of type B aortic dissection (TBAD) is debated, especially with advances in endovascular treatments.
- This study evaluates outcomes and complications of various TBAD treatment strategies.
Purpose of the Study:
- To compare the outcomes and complication rates of different treatment paradigms for type B aortic dissection (TBAD).
- To identify predictors of mortality in patients with TBAD.
Main Methods:
- Retrospective review of 134 patients with TBAD from 2006 to 2012.
- Comparison of surgical interventions (TEVAR and open surgery) versus medical therapy.
- Survival analysis using Kaplan-Meier and Cox proportional hazards models.
Main Results:
- Overall 30-day mortality was 7%; 5-year survival was 57%, with no significant difference between medical and surgical groups (P=0.8).
- Aneurysmal expansion occurred in 50% of patients, requiring surgery in 26.
- Renal insufficiency, age, and rupture were independent predictors of mortality.
Conclusions:
- Medical therapy is the primary treatment for TBAD, associated with low morbidity.
- Surgical intervention is indicated for selected patients with malperfusion or aneurysmal expansion, demonstrating comparable survival rates.
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