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Thoracic endovascular aortic repair for retrograde type A aortic dissection with an entry tear in the descending aorta.
J Vasc Interv Radiol 2012; 23(4):453-60, 460.e1JV

Abstract

PURPOSE

To report the immediate and follow-up outcome of thoracic endovascular aortic repair (TEVAR) in highly selected patients with retrograde type A aortic dissection (RAAD) and an entry tear in the descending aorta.

MATERIALS AND METHODS

TEVAR was performed in 17 patients with RAAD and an entry tear in the descending aorta. None of the patients had severe aortic regurgitation, cardiac tamponade, coronary artery involvement, or brain ischemia. The false lumen in the ascending aorta was patent in nine patients. Two patients had acute malperfusion of the branched artery. Computed tomography (CT) was performed 14 days, 3 months, and 6 months after the intervention and annually thereafter.

RESULTS

All procedures were technically successful, with complete coverage of the entry tear and complete thrombosis of the false lumen in the ascending aorta. All patients survived through the follow-up period (25.7 months ± 17.2). TEVAR resulted in thrombosis of the false lumen, reabsorption of the false lumen thrombus, and enlargement of the true lumen. The mean maximal diameter of the ascending aorta and the false lumen in the ascending aorta significantly decreased after TEVAR. At the distal edge of the stent graft, the mean diameter of the descending aorta and the false lumen markedly decreased after TEVAR. Complete thrombosis of the false lumen was observed at the distal edge of the stent graft in 16 (94.1%) patients and at the diaphragmatic level in 9 (52.9%) patients.

CONCLUSIONS

TEVAR for RAAD with an entry tear in the descending aorta is a safe and effective technique in highly selected patients.

Authors+Show Affiliations

Department of Vascular Surgery, The 2nd Xiang-ya Hospital of Central-south University, Changsha, Hunan, China. changshu_vascular@163.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article

Language

eng

PubMed ID

22464711

Citation

Shu, Chang, et al. "Thoracic Endovascular Aortic Repair for Retrograde Type a Aortic Dissection With an Entry Tear in the Descending Aorta." Journal of Vascular and Interventional Radiology : JVIR, vol. 23, no. 4, 2012, pp. 453-60, 460.e1.
Shu C, Wang T, Li QM, et al. Thoracic endovascular aortic repair for retrograde type A aortic dissection with an entry tear in the descending aorta. J Vasc Interv Radiol. 2012;23(4):453-60, 460.e1.
Shu, C., Wang, T., Li, Q. M., Li, M., Jiang, X. H., Luo, M. Y., & Li, X. (2012). Thoracic endovascular aortic repair for retrograde type A aortic dissection with an entry tear in the descending aorta. Journal of Vascular and Interventional Radiology : JVIR, 23(4), pp. 453-60, 460.e1. doi:10.1016/j.jvir.2011.12.023.
Shu C, et al. Thoracic Endovascular Aortic Repair for Retrograde Type a Aortic Dissection With an Entry Tear in the Descending Aorta. J Vasc Interv Radiol. 2012;23(4):453-60, 460.e1. PubMed PMID: 22464711.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Thoracic endovascular aortic repair for retrograde type A aortic dissection with an entry tear in the descending aorta. AU - Shu,Chang, AU - Wang,Tun, AU - Li,Quan-Ming, AU - Li,Ming, AU - Jiang,Xiao-Hua, AU - Luo,Ming-Yao, AU - Li,Xin, PY - 2011/08/17/received PY - 2011/12/21/revised PY - 2011/12/26/accepted PY - 2012/4/3/entrez PY - 2012/4/3/pubmed PY - 2012/8/8/medline SP - 453-60, 460.e1 JF - Journal of vascular and interventional radiology : JVIR JO - J Vasc Interv Radiol VL - 23 IS - 4 N2 - PURPOSE: To report the immediate and follow-up outcome of thoracic endovascular aortic repair (TEVAR) in highly selected patients with retrograde type A aortic dissection (RAAD) and an entry tear in the descending aorta. MATERIALS AND METHODS: TEVAR was performed in 17 patients with RAAD and an entry tear in the descending aorta. None of the patients had severe aortic regurgitation, cardiac tamponade, coronary artery involvement, or brain ischemia. The false lumen in the ascending aorta was patent in nine patients. Two patients had acute malperfusion of the branched artery. Computed tomography (CT) was performed 14 days, 3 months, and 6 months after the intervention and annually thereafter. RESULTS: All procedures were technically successful, with complete coverage of the entry tear and complete thrombosis of the false lumen in the ascending aorta. All patients survived through the follow-up period (25.7 months ± 17.2). TEVAR resulted in thrombosis of the false lumen, reabsorption of the false lumen thrombus, and enlargement of the true lumen. The mean maximal diameter of the ascending aorta and the false lumen in the ascending aorta significantly decreased after TEVAR. At the distal edge of the stent graft, the mean diameter of the descending aorta and the false lumen markedly decreased after TEVAR. Complete thrombosis of the false lumen was observed at the distal edge of the stent graft in 16 (94.1%) patients and at the diaphragmatic level in 9 (52.9%) patients. CONCLUSIONS: TEVAR for RAAD with an entry tear in the descending aorta is a safe and effective technique in highly selected patients. SN - 1535-7732 UR - https://www.unboundmedicine.com/medline/citation/22464711/Thoracic_endovascular_aortic_repair_for_retrograde_type_A_aortic_dissection_with_an_entry_tear_in_the_descending_aorta_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1051-0443(11)01643-5 DB - PRIME DP - Unbound Medicine ER -