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A New Murine Model of Endovascular Aortic Aneurysm Repair
Published on: July 7, 2013
Early and midterm outcomes of endovascular treatment for chronic aneurysmal aortic dissection: a retrospective study
Yuji Kanaoka1, Takao Ohki2, Koji Kurosawa3
1Division of Vascular Surgery, Department of Surgery, Jikei University School of Medicine, 3-25-8, Nishi-shinbashi, Minato-ku, Tokyo 105-8461, Japan.
Insights
Endovascular repair offers favorable outcomes for chronic aneurysmal aortic dissection (CAAD), showing reduced mortality compared to open repair. This minimally invasive approach demonstrates promising early and midterm results for patients with CAAD.
Area of Science:
- Cardiovascular Surgery
- Vascular Surgery
- Interventional Cardiology
Background:
- Chronic aneurysmal aortic dissection (CAAD) presents a high-risk treatment challenge, with conventional open repair associated with significant operative mortality.
- Endovascular treatment is emerging as a less invasive alternative for managing CAAD.
Purpose of the Study:
- To evaluate the efficacy and outcomes of endovascular treatment for enlarged Stanford type B chronic aneurysmal aortic dissection (CAAD).
Main Methods:
- A retrospective single-center study included 74 patients with CAAD undergoing endovascular repair over 8.5 years.
- Patients were divided into partial exclusion (PE) and complete exclusion (CE) groups based on stent graft closure strategies.
- The CE group aimed to close all entry and reentry sites, while the PE group focused on closing entry sites near the maximum diameter.
Main Results:
- Operative mortality was 2.3% in the PE group and 0% in the CE group.
- Complete tear closure was achieved in 54.8% of CE patients; complete false lumen thrombosis occurred in only 2.3% of PE patients.
- Freedom from secondary intervention at 1 year was 92.9% for successful CE cases and 69.1% for unsuccessful CE cases.
Conclusions:
- Endovascular treatment for CAAD demonstrates favorable early and midterm outcomes.
- The CE strategy showed promising results with reduced operative mortality and good freedom from secondary interventions.
Background:
The aim of this study was to evaluate endovascular treatment for enlarged Stanford type B chronic aneurysmal aortic dissection (CAAD). The conventional treatment for CAAD is open repair; however, the operative mortality is high in extensive prosthetic graft replacements.
Methods:
A retrospective single-center study was conducted on 74 consecutive patients who underwent endovascular treatment for CAAD in the past 8.5 years. In the partial exclusion (PE) group, entry sites in close proximity to the maximum diameter of CAAD were closed using a stent graft and reentry sites were left without closure. In the complete exclusion (CE) group, we attempted to close all entry and reentry sites.
Results:
A total of 43 patients (PE group) and 31 patients (CE group) were included with mean ages of 59 and 63 years, respectively. Operative mortalities of 2.3% and 0% were observed in the PE and CE groups, respectively. Complete tear closure was successful in 17 of 31 patients (54.8%) in the CE group. In the PE group, complete thrombosis of the false lumen was achieved in only one case (2.3%). Freedom rates from reentry closure were 90.2%, 86.9%, and 78.2% at 1, 3, and 5 years, respectively. The diameter of the true lumen/aorta changed from 16.9/62.9 mm to 30.2/53.6 mm and from 13.7/55.1 mm to 25.8/51.0 mm in the aortic arch and descending thoracic aorta, respectively. The freedom rates from secondary intervention in successful and unsuccessful CE cases were 92.9% and 69.1%, respectively, at 1 year and 92.9% and 53.7%, respectively, at 3 years.
Conclusion:
Endovascular treatment for CAAD had favorable early and midterm outcomes.
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