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Dynamic and Static Vessel Malperfusion as a Consequence of Acute Type B Aortic Dissection
Mohamad Bashir1, Matti Jubouri2, Richard D White3
1Vascular and Endovascular Surgery, Velindre University NHS Trust, Health Education and Improvement Wales (HEIW), Cardiff.
Annals of Vascular Surgery
|December 8, 2022
Summary
Thoracic endovascular aortic repair (TEVAR) effectively treats acute type B aortic dissection (TBAD) with organ malperfusion. Maintaining true lumen perfusion to abdominal organs post-TEVAR is crucial for successful outcomes in complicated TBAD cases.
Area of Science:
- Cardiovascular Surgery
- Vascular Surgery
- Endovascular Interventions
Background:
- Acute type B aortic dissection (TBAD) is a rare but serious condition.
- TBAD can lead to organ malperfusion due to dissection flap propagation.
- Thoracic endovascular aortic repair (TEVAR) is a safe and effective treatment for TBAD.
Purpose of the Study:
- To evaluate TEVAR outcomes in acute TBAD patients with organ malperfusion.
- To analyze the perfusion of vital organs after TEVAR in TBAD.
- To identify factors influencing outcomes in complicated TBAD treated with TEVAR.
Main Methods:
- Retrospective analysis of 28 TBAD patients treated with TEVAR over 16 years.
- Diagnosis and extent classification using CT scans.
- Blood pressure management and subsequent TEVAR procedures.
Main Results:
- 8 out of 25 TEVAR patients (32%) presented with organ malperfusion.
- Hypertension was the most common symptom (89%).
- True lumen perfusion to abdominal organs was maintained in most malperfusion patients post-TEVAR.
Conclusions:
- Complicated TBAD progression is unpredictable.
- Maintaining true lumen perfusion to abdominal vessels post-TEVAR is vital for optimal results.
- TEVAR is a viable option for TBAD with malperfusion.
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