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Thoracic Endovascular Aortic Repair With Additional Distal Bare Stents in Type B Aortic Dissection Does Not Prevent Long-Term Aneurysmal Degeneration
- Source :
- Journal of endovascular therapy : an official journal of the International Society of Endovascular Specialists. 28(3)
- Publication Year :
- 2021
-
Abstract
- Purpose: TEVAR (thoracic endovascular aortic repair) + PETTICOAT (Provisional ExTension to Induce COmplete ATtachment) technique has been selectively employed since 2005 at our institution during endovascular treatment of type B aortic dissection (TBD). The aim of this study is to evaluate the long-term (>5 years) clinical results and the evolution of aortic volume. Materials and Methods: All the patients receiving an endovascular treatment for TBD with the PETTICOAT technique were collected in a prospectively maintained database and follow-up computed tomography scan were retrospectively analyzed. Study endpoints included short- and long-term clinical success (absence of need for reintervention) and any major adverse event. The volumes of thoracic and abdominal aorta at long-term follow-up were also analyzed. Results: Twenty-eight patients received a TEVAR + PETTICOAT and were followed up (median follow-up 85 months). Primary 30-day clinical success rate was 82% with an adverse event rate of 31%; 4 type I endoleak and 1 retrograde dissection were recorded. Secondary mid-term clinical success was 96% while the long-term clinical success rate was 79%. Six cases (21%) received either an open repair or an endovascular repair for a significant distal aortic enlargement at follow-up. With regards to volumetric analysis, an increase of overall (thoracic and abdominal) aortic volume was observed in 8 cases mainly related to an increase (mean: +31%) of the abdominal volume that was observed in 11 cases. Conclusions: PETTICOAT technique does not protect from long-term significant aneurysmal degeneration that may require aortic open or endovascular reinterventions. Aortic growth occurs mainly in the bare-stented aorta and thus, life-long surveillance is advisable in these patients.
- Subjects :
- endovascular treatment
medicine.medical_specialty
Degeneration (medical)
Aortic repair
Blood Vessel Prosthesis Implantation
medicine
Humans
aortic volume
PETTICOAT
TEVAR
type B aortic dissection
Radiology, Nuclear Medicine and imaging
Endovascular treatment
Retrospective Studies
Aortic Aneurysm, Thoracic
Type B aortic dissection
business.industry
Endovascular Procedures
Surgery
Blood Vessel Prosthesis
Aortic Dissection
Treatment Outcome
Stents
Cardiology and Cardiovascular Medicine
business
Subjects
Details
- ISSN :
- 15451550
- Volume :
- 28
- Issue :
- 3
- Database :
- OpenAIRE
- Journal :
- Journal of endovascular therapy : an official journal of the International Society of Endovascular Specialists
- Accession number :
- edsair.doi.dedup.....61a4baec149432ab2d72cf813201587d