Early and Long-term Outcome after Thoracic Endovascular Aortic Repair (TEVAR) for Acute Complicated Type B Aortic Dissection

• Published in: European journal of vascular and endovascular surgery Vol. 41; no. 3; pp. 318 - 323
• Main Authors: Steuer, J, Eriksson, M.-O, Nyman, R, Björck, M, Wanhainen, A
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01-03-2011
• Subjects: Acute Disease; Adult; Aged; Aged, 80 and over; Aneurysm, Dissecting - diagnostic imaging; Aneurysm, Dissecting - mortality; Aneurysm, Dissecting - surgery; Aortic Aneurysm, Thoracic - diagnostic imaging; Aortic Aneurysm, Thoracic - mortality; Aortic Aneurysm, Thoracic - surgery; Aortic dissection-acute; Aortic dissection-complicated; Aortography - methods; Blood Vessel Prosthesis Implantation - adverse effects; Blood Vessel Prosthesis Implantation - mortality; Endovascular Procedures - adverse effects; Endovascular Procedures - mortality; Endovascular repair; Female; Hospital Mortality; Humans; Kaplan-Meier Estimate; Male; MEDICIN; MEDICINE; Middle Aged; Paraplegia - etiology; Re-intervention; Reoperation; Retrospective Studies; Stroke - etiology; Surgery; Survival; Survival Rate; Sweden; TEVAR; Time Factors; Tomography, X-Ray Computed; Treatment Outcome; Aortic dissection-complicated; Aortic dissection-acute; Re-intervention; Survival; TEVAR; Endovascular repair
• ISSN: 1078-5884; 1532-2165; 1532-2165
• DOI: 10.1016/j.ejvs.2010.11.024

Abstract Objectives The study aimed to investigate early and long-term outcome of thoracic endovascular aortic repair (TEVAR) for acute complicated type B dissection. Design This was a retrospective, single-centre, consecutive case series. Materials and Methods During the period 1999–2009, TEVAR was carried out in 50 patients with non-traumatic acute complicated type B dissection, and in another 10 patients with acute complications, including rupture, end-organ ischaemia and acute dilatation during the primary hospitalisation, but >14 days after onset of symptoms. Thus, in total, 60 patients were included; 22 with a DeBakey type IIIa dissection and 38 with a type IIIb; median age was 67 years. Early (30-day) and long-term (5-year) survival, re-intervention rate and complications were recorded until 1 July 2010. Results Within 30 days, two (3%) deaths, one (2%) paraplegia and three (5%) strokes were observed. Five-year survival was 87% and freedom from re-intervention at 5 years was 65%. Conclusions In patients with acute complicated type B aortic dissection, TEVAR can be performed with excellent early and long-term survival, whereas morbidity and long-term durability must be further elucidated.