Outcomes of Stentless Thoracic Endovascular Aortic Repair for Chronic DeBakey IIIb Aneurysms
| Autor: | Min-Young Baek, Bum-Koo Cho, Suk-Won Song, Woon Heo, Kwang Hun Lee, Tae-Hoon Kim, Kyung-Jong Yoo |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Male
Pulmonary and Respiratory Medicine medicine.medical_specialty Computed Tomography Angiography medicine.medical_treatment Lumen (anatomy) Vascular Remodeling 030204 cardiovascular system & hematology Risk Assessment Statistics Nonparametric 030218 nuclear medicine & medical imaging Cohort Studies Blood Vessel Prosthesis Implantation 03 medical and health sciences Aortic aneurysm 0302 clinical medicine medicine.artery Republic of Korea medicine Humans Thoracic aorta Hospital Mortality Aged Proportional Hazards Models Retrospective Studies Aortic Aneurysm Thoracic business.industry Endovascular Procedures Hazard ratio Stent Middle Aged medicine.disease Thrombosis Surgery Survival Rate Treatment Outcome Cardiothoracic surgery Chronic Disease Multivariate Analysis Pulmonary artery Female Stents Cardiology and Cardiovascular Medicine business Follow-Up Studies |
| Zdroj: | The Annals of Thoracic Surgery. 106:1308-1315 |
| ISSN: | 0003-4975 |
| Popis: | Background We introduce a new endovascular procedure for favorable aortic remodeling in patients with chronic DeBakey IIIb (CDIIIb) aneurysms and present outcomes. Methods This study included 19 patients who underwent stentless thoracic endovascular aortic repair (TEVAR) for CDIIIb aneurysms between 2014 and 2016. Stentless TEVAR is defined as an endovascular procedure involving closure of communicating channels or obliteration of the false lumen itself using various materials. Thoracic false lumen thrombosis was defined as there was no flow in the false lumen of the thoracic aorta. Aortic diameter was measured at 3 levels (left subclavian artery, pulmonary artery bifurcation, and celiac axis). Results Fifteen of 19 (78.9%) patients demonstrated thoracic false lumen thrombosis. There was no mortality, and the mean follow-up duration was 16.8 months. False and true lumen diameters at the left subclavian and pulmonary artery levels significantly changed after the procedure (false lumen: 22.6 ± 16.6 versus 16.1 ± 14.4 mm, 23.2 ± 14.6 versus 18.0 ± 13.2 mm, p = 0.001 and p = 0.002, respectively; true lumen: 22.7 ± 8.7 versus 27.9 ± 6.3 mm, 19.0 ± 8.3 versus 24.3 ± 6.7 mm, p = 0.001 and p = 0.001, respectively). The number of visceral stent grafts and preoperative true lumen diameter at the pulmonary artery were independent predictors for thoracic false lumen thrombosis (hazard ratio, 3.445, 95% confidence interval, 1.494 to 7.946; p = 0.004; and hazard ratio, 1.106; 95% confidence interval, 1.029 to 1.189; p = 0.006, respectively). Conclusions Stentless TEVAR seems to be a safe procedure and enables favorable aortic remodeling. Thus, this technique can be useful in a selected group of patients with CDIIIb aneurysms. |
| Databáze: | OpenAIRE |
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