3D Morphologic Findings Before and After Thoracic Endovascular Aortic Repair for Type B Aortic Dissection.

Autor:	Sun W; Laboratory of Image Science and Technology, Key Laboratory of Computer Network and Information Integration, School of Computer Science and Engineering, Southeast University, Nanjing, China; Centre de Recherche en Information BioMdicale Sino-franais (CRIBs), Nanjing, China., Xu H; School of Life Science, Beijing Institute of Technology, Beijing, China., Xiong J; Department of Vascular and Endovascular Surgery, Chinese PLA General Hospital, Beijing, China., Li Z; School of Life Science, Beijing Institute of Technology, Beijing, China., Chen Y; Laboratory of Image Science and Technology, Key Laboratory of Computer Network and Information Integration, School of Computer Science and Engineering, Southeast University, Nanjing, China; Centre de Recherche en Information BioMdicale Sino-franais (CRIBs), Nanjing, China., Yang G; Laboratory of Image Science and Technology, Key Laboratory of Computer Network and Information Integration, School of Computer Science and Engineering, Southeast University, Nanjing, China; Centre de Recherche en Information BioMdicale Sino-franais (CRIBs), Nanjing, China., Shu H; Laboratory of Image Science and Technology, Key Laboratory of Computer Network and Information Integration, School of Computer Science and Engineering, Southeast University, Nanjing, China; Centre de Recherche en Information BioMdicale Sino-franais (CRIBs), Nanjing, China. Electronic address: shu.list@seu.edu.cn., Chen D; School of Life Science, Beijing Institute of Technology, Beijing, China. Electronic address: duanduan@bit.edu.cn.
Jazyk:	angličtina
Zdroj:	Annals of vascular surgery [Ann Vasc Surg] 2021 Jul; Vol. 74, pp. 220-228. Date of Electronic Publication: 2021 Jan 27.
DOI:	10.1016/j.avsg.2020.12.026
Abstrakt:	Background: Stanford type-B aortic dissection (TBAD) is commonly treated by thoracic endovascular aortic repair (TEVAR). Usually, the implanted stent-grafts will not cover the entire dissection-affected region for those patients with dissection extending beyond the thoracic aorta, thus the fate of the uncovered aortic segment is uncertain. This study used 3-dimensional measurement of aortic morphological changes to classify the different remodeling effects of TBAD patients after TEVAR, and hypothesized that not only initial morphological features, but also their change over time at follow-up are associated with the remodeling. Methods: Forty-one TBAD patients underwent TEVAR and CT-angiography before and after the intervention (twice or more follow-ups) were included in this study. According to the false-lumen volume variations post-TEVAR, patients who had abdominal aortic expansion at the second follow-up were classified into the Enlarged (n =12, 29%) and remaining into the Stable group (n = 29, 71%). 3D morphological parameters were extracted on precise reconstruction of imaging datasets. Statistical differences in 3D morphological parameters over time between the 2 groups and the relationship among these parameters were analyzed. Results: In the Enlarged group, the number of all tears before TEVAR was significantly higher (P = 0.022), and the size of all tears at the first and second follow-up post-TEVAR were significantly higher than that in the Stable group (P = 0.008 and P = 0.007). The location of the primary tear was significantly higher (P = 0.031) in the Stable group. The cross-sectional analysis of several slices below the primary tear before TEVAR shows different shape features of the false lumen in the Stable (cone-like) and Enlarged (hourglass-like) groups. The number of tears before TEVAR has a positive correlation with the post-TEVAR development of dissection (r = 0.683, P = 0.00). Conclusion: The results in this study indicated that the TBAD patients with larger tear areas, more re-entry tears and with the primary tear proximal to the arch would face a higher risk of negative remodeling after TEVAR. (Copyright © 2021 Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu