Implantation sequence modification averts distal stent graft-induced new entry after endovascular repair of Stanford type B aortic dissection

Autor: Po-Lin Chen, Ping-Yi Lin, Chun-Yang Huang, Shih-Hsien Weng, Chun-Che Shih, Wei-Yuan Chen, I-Ming Chen
Rok vydání: 2016
Předmět:
Male
Time Factors
Computed Tomography Angiography
medicine.medical_treatment
030204 cardiovascular system & hematology
Medical Records
Aortic aneurysm
Postoperative Complications
0302 clinical medicine
Risk Factors
Thoracic aorta
030212 general & internal medicine
Aged
80 and over
education.field_of_study
medicine.diagnostic_test
Endovascular Procedures
Middle Aged
Treatment Outcome
Female
Stents
Radiology
Cardiology and Cardiovascular Medicine
psychological phenomena and processes
Adult
medicine.medical_specialty
Aortography
Adolescent
Population
Taiwan
Lumen (anatomy)
Prosthesis Design
behavioral disciplines and activities
Blood Vessel Prosthesis Implantation
Young Adult
03 medical and health sciences
Aneurysm
Blood vessel prosthesis
medicine.artery
medicine
Humans
education
Aged
Retrospective Studies
Aortic Aneurysm
Thoracic
business.industry
Stent
medicine.disease
Blood Vessel Prosthesis
Surgery
Aortic Dissection
business
Zdroj: Journal of Vascular Surgery. 64:281-288
ISSN: 0741-5214
DOI: 10.1016/j.jvs.2016.02.032
Popis: Objective This study investigated predisposing factors of distal stent graft-induced new entry (SINE). Methods Data from November 2006 to May 2012 were abstracted retrospectively from the records of 73 patients with complicated type B aortic dissection who had received stent graft treatment in our institution. Diameters of the true and false lumen, area and circumference of the true lumen, prestent and poststent oversize, taper, and mismatch ratio were recorded and analyzed to see if there were any significant differences between the SINE (n = 19) and non-SINE (n = 54) population and between those in whom the initial endograft was inserted from the proximal thoracic aorta (n = 49) or the distal thoracic aorta (n = 24). Results A distal-first sequence of stent graft deployment produced significantly fewer instances of distal SINE. The area oversizing ratio of the distal end of the stent graft was greater in the SINE vs non-SINE groups (3.76 ± 1.7 vs 2.63 ± 2.57; P = .002) and in the proximal-first vs distal-first deployment sequence groups (3.67 ± 2.57 vs 1.39 ± 0.90; P Conclusions Minimizing the preprocedure distal oversizing ratio with a distal small graft-first procedure could reduce the risk of late distal SINE for Stanford type B aortic dissection. Furthermore, the area ratio is a potentially more sensitive modality for size assessment and prediction of distal SINE occurrence.
Databáze: OpenAIRE
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