scholarly journals Medium-Term Results of Treatment for Complicated Acute Type B Dissection: A Spanish Experience in a Single Centre

2014 ◽  
Vol 2014 ◽  
pp. 1-6
Author(s):  
Jesus Alvarez-Garcia ◽  
Stefan Stefanov Kiuri ◽  
Alvaro Fernandez Heredero ◽  
Andres Salazar Alvarez ◽  
Nieves Aleicel Concepcion Rodriguez ◽  
...  
Keyword(s):  
Endovascular Treatment ◽  
Hypertensive Crisis ◽  
Type I ◽  
Acute Type ◽  
Type B ◽  
Medium Term ◽  
Results Of Treatment ◽  
Type B Dissection ◽  
Type I Endoleak

Objective. To analyze and evaluate medium-term results obtained in endovascular treatment of complicated type B dissection. Methods. Prospective registry and retrospective analysis of the dissections treated with endoprosthesis in 1998 and 2010. Comorbidity, clinical presentation, anatomical characteristics, and evolution were recorded. Actuarial analysis was conducted for survival, follow-up and survival free of endoleaks, and free of reintervention due to relapse and/or progression. Results. Eighteen (18) patients were treated (14 male : 4 female), with a median age of 53 years (range 29–80). Their main symptoms were acute pain in 16 cases and hypertensive crisis in 15. The indications were 10 dissections not controlled by medication, 4 aneurysm dissecans, 2 acute lower limb ischemias, and 2 Type A progressions. Median 1.7 devices were used (range 1–4). Coverage of left subclavian artery was required in 3 cases, and of subclavian and left carotid artery in other 2 cases. There was a 100% technical success. Median follow-up was 43.1 months (1.5–127 range). There were two deaths caused by multiorganic failure, early mortality of 0%, and hospital mortality of 11%. There was a case of Type I Endoleak and 5 cases which required a new intervention due to relapse and/or progression. Cumulative survival at 30 months was 88%; follow-up free of endoleaks at 36 months was 91%. Follow-up free of progression/relapse at 12 months was 88%. Conclusion. Endovascular treatment of complicated type B acute dissection is an effective therapy for this condition, with a low associated mortality and with acceptable survival.

Outcomes of Thoracic Endovascular Aneurysm Repair (TEVAR) in Patients With Connective Tissue Disorders

2020 ◽  
Vol 54 (8) ◽  
pp. 676-680
Author(s):  
Khalil Qato ◽  
Allan Conway ◽  
Eileen Lu ◽  
Nhan Nguyen Tran ◽  
Gary Giangola ◽  
...  
Keyword(s):  
Connective Tissue ◽  
Thoracic Endovascular Aortic Repair ◽  
Endovascular Aortic Repair ◽  
Acute Type ◽  
Type B ◽  
Connective Tissue Disorders ◽  
Aortic Repair ◽  
Type B Dissection ◽  
Significant Difference

Objectives: Thoracic endovascular aortic repair (TEVAR) remains controversial in patients with connective tissue disorders given the concern for durability. We report on the largest series to date on outcomes of patients with thoracic aortic disease and connective tissue disorders treated with TEVAR. Methods: The Vascular Quality Initiative registry identified 12 207 patients treated with TEVAR from January 2010 to December 2018, including 102 with Marfans, Ehlers-Danlos, or Loey-Dietz syndrome. Outcomes were analyzed per the Society for Vascular Surgery reporting standards. Results: Median age was 50.6 years (interquartile range: 57.0-75.0), and 62 (60.7%) were male. Eighty-eight (86.3%) patients had Marfan, 9 (8.8%) had Ehlers-Danlos, and 5 (4.9%) had Loey-Dietz syndrome. Twenty-six (25.5%) patients were treated for degenerative aneurysmal disease and 76 (74.5%) patients for type B dissections (33 acute, 31 chronic). Most common indications for interventions in patients with type B dissection were pain (n = 41), aneurysmal degeneration (n = 16), and malperfusion (n = 8), with 3 patients who presented ruptured. There was no significant difference in perioperative complications between acute/chronic dissections and aneurysms ( P = .14). Percutaneous access was utilized in 61.7% of patients, with a 2.9% rate of arterial injury requiring reintervention. Follow-up data were available for 75 (73.3%) patients at a mean follow-up of 15.6 months. Overall mortality was 5.3%. There were 30 patients with follow-up endoleak data, and 8 (26.7%) endoleaks were identified. All endoleaks were in patients treated for acute type B dissection, and all resolved after a mean of 2.1 reinterventions. Three patients treated for acute Type B Aortic Dissection (TBAD) had retrograde dissections requiring intervention. Discussion: Thoracic endovascular aortic repair for patients with connective tissue disorders can be performed with low perioperative mortality, spinal cord ischemia, or Cerebrovascular Accident (CVA). On follow-up, acute type B aortic dissections represent a higher risk subgroup with increased rates of endoleak and retrograde dissection. Closer follow-up for these patients and early reintervention may be beneficial.

scholarly journals Endovascular treatment of acute type B dissection complicating graft-bypass repair for aortic coarctation

2015 ◽  
Vol 28 ◽  
pp. 11-13
Author(s):  
Serkan Ertugay ◽  
Hakan Posacıoglu ◽  
Mustafa Parildar ◽  
Halil Bozkaya
Keyword(s):  
Endovascular Treatment ◽  
Aortic Coarctation ◽  
Acute Type ◽  
Type B ◽  
Type B Dissection

Quality of life after acute type b dissection in the era of thoracic endovascular aortic repair

VASA ◽  
2010 ◽  
Vol 39 (3) ◽  
pp. 219-228 ◽  
Author(s):  
Dick ◽  
Hirzel ◽  
Immer ◽  
Hinder ◽  
Dai-Do ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Endovascular Aortic Repair ◽  
Acute Type ◽  
Type B ◽  
Type B Aortic Dissection ◽  
Aortic Repair ◽  
Type B Dissection

Background: Conservative management of acute type B aortic dissection is currently being challenged by primary thoracic endovascular aortic repair. Aim was to assess outcome and quality of life after these different approaches using an adjusted standard population as benchmark. Patients and methods: Observational study of a prospectively collected (January 2000 to December 2005) consecutive series of 87 patients with acute type B aortic dissection. Patients were 63 ± 13 years old and 68 were men (78.2 %). Seventy-two were managed conservatively (83 %) and 15 invasively (12 by endovascular aortic repair). Follow-up was 36 ± 19 months. Endpoints were early and late morbidity and mortality, and long-term quality of life as assessed by the Short Form health survey questionnaire. Results: Patient cohorts were similar regarding age, risk profile and local disease. In the conservative cohort, four patients died during early (5.6 %) and eight during long-term follow-up (cumulative four years survival rate 79 %). Thirty-two patients needed secondary surgical management (44 %), i.e. delayed aortic repair (n = 11), or interventions on adjacent aortic sections or major branches (n = 21). In the surgical cohort no patient died, and no repeated interventions were necessary after the peri-operative period. Long-term quality of life scores were 100 (69-115) in conservatively and 94 (75-124) in invasively managed patients. Normal scores range from 85 to 115. Conclusions: Primary endovascular management of uncomplicated acute type B dissection is safe and leads to excellent long-term results, whereas secondary interventions were required with high incidence after initial conservative management. Long-term quality of life, however, returned to normal with any successful treatment strategy.

Endovascular Treatment of an Acute Type B Dissection: a Case Report

2001 ◽  
Vol 101 (5) ◽  
pp. 250-252
Author(s):  
F. Depuydt ◽  
E. Demirsoy ◽  
J. Coddens ◽  
I. Degrieck ◽  
H. Vanermen
Keyword(s):  
Case Report ◽  
Endovascular Treatment ◽  
Acute Type ◽  
Type B ◽  
Type B Dissection

Determining Surgical Indications for Acute Type B Dissection Based on Enlargement of Aortic Diameter During the Chronic Phase

Circulation ◽  
1995 ◽  
Vol 92 (9) ◽  
pp. 107-112 ◽  
Author(s):  
Masaaki Kato ◽  
Hong-zhi Bai ◽  
Kenji Sato ◽  
Seiichi Kawamoto ◽  
Mitsunori Kaneko ◽  
...  
Keyword(s):  
Chronic Phase ◽  
Aortic Diameter ◽  
Acute Type ◽  
Type B ◽  
Surgical Indications ◽  
Type B Dissection

STABILISE for Complicated Type B Dissection after 15 Months’ Follow Up: A Word of Caution

2021 ◽  
Author(s):  
Raphael Soler ◽  
Michel A. Bartoli ◽  
Philippe Amabile ◽  
Gabrielle Sarlon-Bartoli ◽  
Pierre-Édouard Magnan
Keyword(s):  
Type B ◽  
Type B Dissection
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