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Long-term outcomes of thoracic endovascular aortic repair for chronic Stanford type B aortic dissection

Xiang Hong1, Yue Lin1, Xinsehng Xie1

  • 1Department of Vascular Surgery, Zhongshan Hospital (Xiamen) Fudan University, Xiamen, China.

Vascular
|January 23, 2023
PubMed

Insights

Proximal thoracic endovascular aortic repair (TEVAR) is a safe and effective treatment for chronic Stanford type B aortic dissection (cTBAD). This procedure promotes positive aortic remodeling and offers favorable long-term survival and low reintervention rates.

Area of Science:

  • Cardiovascular Surgery
  • Vascular Surgery
  • Endovascular Interventions

Background:

  • Chronic Stanford type B aortic dissection (cTBAD) presents complex management challenges.
  • Long-term outcomes of proximal thoracic endovascular aortic repair (TEVAR) for cTBAD require further elucidation.

Purpose of the Study:

  • To evaluate the long-term clinical outcomes and aortic remodeling following proximal TEVAR in patients with cTBAD.
  • To assess survival rates and the need for reintervention after TEVAR for cTBAD.

Main Methods:

  • Retrospective analysis of 48 cTBAD patients undergoing proximal TEVAR.
  • Collection of preoperative and postoperative imaging, survival, and reintervention data.
  • Follow-up included imaging and clinical assessment at regular intervals up to 10 years.

Main Results:

  • Significant positive remodeling of the descending aorta was observed, with increased true lumen diameter and decreased false lumen diameter.
  • The 5-year and 10-year freedom from reintervention rates were 81% and 50.6%, respectively.
  • The overall 10-year survival rate was 83%, and the aortic-related survival rate was 92.3%.

Conclusions:

  • Proximal TEVAR is a safe and effective intervention for cTBAD.
  • TEVAR reliably induces positive aortic remodeling in the descending aorta.
  • The procedure demonstrates favorable long-term survival and low reintervention rates.
Abstract

Keywords:
Stanford type Baortic dissectionchronicendovascular repairremodeling

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