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Outflow Through Aortic Side Branches Drives False Lumen Patency in Type B Aortic Dissection
Gerlinde Logghe1, Bram Trachet1, Patrick Segers1
1Institute for Biomedical Engineering and Technology, Ghent University, Ghent, Belgium.
Frontiers in Cardiovascular Medicine
|September 6, 2021
Summary
The number of side branches from the false lumen (FL) in type B aortic dissection (TBAD) significantly impacts FL patency after thoracic endovascular aortic repair (TEVAR). More branches correlate with poorer FL thrombosis, affecting long-term outcomes.
Area of Science:
- Vascular Surgery
- Cardiovascular Imaging
- Aortic Disease Research
Background:
- Thoracic endovascular aortic repair (TEVAR) for type B aortic dissection (TBAD) aims to achieve false lumen (FL) thrombosis.
- Incomplete FL thrombosis is linked to adverse clinical outcomes.
- The influence of FL side branches on thrombosis after TEVAR is not fully understood.
Purpose of the Study:
- To investigate the hypothesis that the number of major and minor branches arising from the FL affects FL patency.
- To determine if these branches negatively influence TEVAR-induced FL thrombosis.
- To identify predictors of FL thrombosis status in TBAD patients.
Main Methods:
- Retrospective analysis of CT-scans from 89 TBAD patients (52 BMT, 37 TEVAR).
- Evaluation of FL patency, intimal tear characteristics, and FL side branches (major and minor).
- Multiple regression analysis to assess predictors of FL thrombosis.
Main Results:
- The number of major and minor side branches originating from the FL strongly correlated with FL patency.
- In regression analysis, major and minor FL branches were significant predictors of FL axial length.
- Branch numbers determined the length of patent FL at 12-month follow-up in TEVAR patients.
Conclusions:
- The number of minor side branches from the FL is a crucial determinant of FL patency in TBAD.
- This finding is more significant than previously recognized.
- Understanding branch anatomy may improve TEVAR outcomes for TBAD.
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