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Dynamic Indicators That Impact the Outcomes of Thoracic Endovascular Aortic Repair in Complicated Type B Aortic Dissection
- Source :
- Journal of Vascular and Interventional Radiology. 31:760-768.e1
- Publication Year :
- 2020
- Publisher :
- Elsevier BV, 2020.
-
Abstract
- To investigate dynamic variables obtained from retrospective computed tomography angiography for ability to predict thoracic endovascular aortic repair (TEVAR) outcomes in patients with complicated type B aortic dissection (cTBAD).Seventy-nine patients with cTBAD who received TEVAR from March 2009 to June 2018 were retrospectively enrolled. Relative true lumen area (r-TLA) was computed at the level of tracheal bifurcation every 5% of all R-R intervals. Parameters that reflect the state of intimal motion were evaluated, including difference between maximum and minimum r-TLA (D-TLA) and true lumen collapse. The endpoints comprised early (≤ 30 days) and late (30 days) outcomes after intervention.Overall early mortality rate was 13.9% (11/79), and early adverse events rate was 24.1% (19/79). Patients who received TEVAR within 2 days of symptom onset demonstrated the worst outcomes. A longer time of r-TLA25% in 1 cardiac cycle (P = .049) and larger D-TLA (P.001) were correlated to an increased early death. In addition, D-TLA was an independent predictor of early mortality. Area under the curve of D-TLA was 0.849 (95% confidence interval 0.730-0.967) for predicting early mortality and 0.742 (95% CI 0.611-0.873) for predicting early adverse events. Survival and event-free survival rates during follow-up were decreased in the D-TLA21.5% group compared with the D-TLA ≤ 21.5% group (all P.001).Larger D-TLA is correlated with worse postoperative outcomes and might be a crucial parameter for future risk stratification in patients with cTBAD.
- Subjects :
- Adult
Male
medicine.medical_specialty
Time Factors
Computed Tomography Angiography
Aorta, Thoracic
Aortic repair
Aortography
Risk Assessment
030218 nuclear medicine & medical imaging
Blood Vessel Prosthesis Implantation
03 medical and health sciences
0302 clinical medicine
Risk Factors
Multidetector Computed Tomography
Humans
Medicine
Radiology, Nuclear Medicine and imaging
In patient
Symptom onset
Adverse effect
Retrospective Studies
Computed tomography angiography
Aortic Aneurysm, Thoracic
medicine.diagnostic_test
business.industry
Type B aortic dissection
Mortality rate
Endovascular Procedures
Hemodynamics
Middle Aged
Progression-Free Survival
Surgery
Aortic Dissection
030220 oncology & carcinogenesis
Tracheal bifurcation
Female
Cardiology and Cardiovascular Medicine
business
Subjects
Details
- ISSN :
- 10510443
- Volume :
- 31
- Database :
- OpenAIRE
- Journal :
- Journal of Vascular and Interventional Radiology
- Accession number :
- edsair.doi.dedup.....1e1a77e2112956c52fd1104befd162a0