Abstract | OBJECTIVE: To compare the short-term efficiency of two different endovascular repairs for type B aortic dissection involving the left subclavian artery. METHODS: From February 2013 to March 2016, a cohort of 43 patients with TBADs involving the LSA underwent thoracic endovascular aortic repair ( TEVAR) in two departments, consisting of 22 (Group A) with chimney grafts (CGs) and 21 (Group B) with single-branched stent graft (SBSG). Results of the two groups in perioperative and follow-up period (≥ 3 months) were comparatively analyzed, especially on aortic remodeling. RESULTS: Endoluminal repair of the two groups was successfully carried out. The median follow-up period was 19 months (range, 3-43 months) in Group A and 12 months in Group B (range, 6-32 months). During the TEVAR, one CG compression occurred in Group A and one type I endoleak in Group B. During follow-up, four complications occurred in Group A (two CGs occlusion, one type I endoleak and one death from dissecting aneurysm rupture), compared with two occurred in Group B (one sidearm graft twist and one death from myocardial infarction). Complete thrombosis of the false lumen (FL) in thoracic aorta was revealed in 83.3% (15/18) cases in Group A and 89.5% (17/19) in Group B. Partial thrombosis of the FL was revealed in 16.7% (3/18) cases in Group A and 10.5% (2/19) in Group B. In the abdominal aorta, complete thrombosis of the FL was noted in 23.1% (3/13) cases in Group A and 36.4% (4/11) in Group B. Partial thrombosis of the FL was revealed in 76.9% (10/13) cases in Group A and 63.6% (7/11) in Group B. Significant true lumen re-expansion and false lumen regression were observed in different levels of the descending aorta by computed tomography angiography (CTA) in both Groups A and B (P < 0.05). No significant diametric changes of abdominal aorta were found during follow-up in both groups. CONCLUSIONS: For patients with TBADs involving the LSA, the chimney technique and the SBSG revealed comparable results. Further evaluation of more patients with longer follow-up is needed to substantiate these results.
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Authors | Honggang Zhang, He Huang, Yepeng Zhang, Zhao Liu, Tong Qiao, Xiwei Zhang, Changjian Liu, Yuanyong Jiao, Min Zhou |
Journal | Cardiovascular and interventional radiology
(Cardiovasc Intervent Radiol)
Vol. 42
Issue 5
Pg. 648-656
(May 2019)
ISSN: 1432-086X [Electronic] United States |
PMID | 30564883
(Publication Type: Comparative Study, Journal Article)
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Topics |
- Aortic Dissection
(diagnostic imaging, surgery)
- Aorta, Abdominal
(diagnostic imaging, surgery)
- Aorta, Thoracic
(diagnostic imaging, surgery)
- Aortic Aneurysm
(diagnostic imaging, surgery)
- Blood Vessel Prosthesis
- Blood Vessel Prosthesis Implantation
(methods)
- Computed Tomography Angiography
- Endovascular Procedures
(methods)
- Female
- Follow-Up Studies
- Humans
- Male
- Middle Aged
- Retrospective Studies
- Stents
- Subclavian Artery
(diagnostic imaging, surgery)
- Treatment Outcome
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