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Thoracic endovascular aortic repair for the treatment of ruptured acute type B aortic dissection

  • Shuji Chino
  • Noriyuki KatoEmail author
  • Ken Nakajima
  • Takashi Hashimoto
  • Takatoshi Higashigawa
  • Takafumi Ouchi
  • Hiroaki Kato
  • Naoki Yamamoto
  • Hisato Ito
  • Yasumi Maze
  • Toshiya Tokui
  • Hajime Sakuma
Original Article
  • 25 Downloads

Abstract

Purpose

To evaluate the efficacy of thoracic endovascular aortic repair (TEVAR) for ruptured acute type B aortic dissection (r-ATBAD).

Materials and methods

The study included 18 patients (15 men and 3 women) who underwent TEVAR for r-ATBAD in two institutions between 1997 and 2017. The mean patient age was 74 ± 10 years. The false lumen was patent in 13 patients (72%) and was mostly thrombosed in 5 patients (28%). Three patients had malperfusion of aortic branches. Eight patients (44%) were in circulatory shock.

Results

Eleven patients (61%) died during or following TEVAR during admission. The causes of death were aortic rupture (n = 6), sepsis (n = 2), cerebral hypoxia (n = 1), pneumonia (n = 1), and renal failure (n = 1). Statistical analysis showed that dissection extending to the infrarenal level was significantly related to death from aortic rupture (P = 0.013). Early adverse events were observed in 12 patients (67%). One patient died from a non-aorta-related cause (sepsis) after discharge. The overall survival rate at 1 year was 39%. After discharge, an aorta-related adverse event (intimal injury) was observed in one patient. The adverse event-free survival rate at 1 year was 17%.

Conclusions

Our results indicate that TEVAR for r-ATBAD is associated with high mortality and morbidity. More advanced strategies may be required to improve the outcome.

Keywords

Aortic dissection Complication Rupture Endovascular repair Stent graft 

Notes

Funding

This research received no specific grant from any funding agency in the public, commercial, or non-profit sectors.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical statement

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in this study.

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Copyright information

© Japan Radiological Society 2019

Authors and Affiliations

  • Shuji Chino
    • 1
  • Noriyuki Kato
    • 1
    Email author
  • Ken Nakajima
    • 1
  • Takashi Hashimoto
    • 1
  • Takatoshi Higashigawa
    • 1
  • Takafumi Ouchi
    • 1
  • Hiroaki Kato
    • 1
  • Naoki Yamamoto
    • 2
  • Hisato Ito
    • 2
  • Yasumi Maze
    • 3
  • Toshiya Tokui
    • 3
  • Hajime Sakuma
    • 1
  1. 1.Department of RadiologyMie University HospitalTsuJapan
  2. 2.Department of Cardiovascular SurgeryMie University HospitalTsuJapan
  3. 3.Department of Cardiovascular SurgeryIse Red Cross HospitalIseJapan

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