scholarly journals Thoracic endovascular aortic repair (TEVAR) versus open versus medical management of type B dissection

2018 ◽  
Vol 4 ◽  
pp. 8-8 ◽  
Author(s):  
Erin Iannacone ◽  
Leonard Girardi
Keyword(s):  
Medical Management ◽  
Thoracic Endovascular Aortic Repair ◽  
Endovascular Aortic Repair ◽  
Type B ◽  
Aortic Repair ◽  
Type B Dissection ◽  
Open Versus

scholarly journals Old Solutions for New Troubles in Complications after Thoracic Endovascular Aortic Repair

2017 ◽  
Vol 06 (01) ◽  
pp. e25-e28
Author(s):  
German Fortunato ◽  
Guillermo Stöger ◽  
Ricardo Marenchino ◽  
Vadim Kotowicz
Keyword(s):  
Aortic Aneurysm ◽  
Thoracic Endovascular Aortic Repair ◽  
Endovascular Aortic Repair ◽  
Type B ◽  
Ascending Aortic Aneurysm ◽  
Endovascular Stent Graft ◽  
Aortic Repair ◽  
First Case ◽  
Type B Dissection

Background The authors present two cases with type B aortic dissection initially treated by endovascular stent graft who developed aortic complications posttreatment and required surgical treatment. Case Description A 50-year-old woman and a 65-year-old man underwent endovascular treatment for thoracic aortic aneurysm associated with type B dissection and —both of them evolved with endoleak type 1. The first case was related to aortobronchial fistula, and the second one was associated with ascending aortic aneurysm. An extra-anatomical ascending aorta-supraceliac aorta bypass grafting was decided due to the persistent leak. Conclusion Surgery is an excellent choice for complex complications after thoracic endovascular aortic repair with previous failed attempts of endovascular resolution.

scholarly journals Thirty-day outcomes from the Society for Vascular Surgery Vascular Quality Initiative thoracic endovascular aortic repair for type B dissection project

2019 ◽  
Vol 69 (3) ◽  
pp. 680-691 ◽  
Author(s):  
Grace J. Wang ◽  
Richard P. Cambria ◽  
Joseph V. Lombardi ◽  
Ali Azizzadeh ◽  
Rodney A. White ◽  
...  
Keyword(s):  
Vascular Surgery ◽  
Thoracic Endovascular Aortic Repair ◽  
Endovascular Aortic Repair ◽  
Type B ◽  
Aortic Repair ◽  
Type B Dissection

Outcomes of Thoracic Endovascular Aneurysm Repair (TEVAR) in Patients With Connective Tissue Disorders

2020 ◽  
Vol 54 (8) ◽  
pp. 676-680
Author(s):  
Khalil Qato ◽  
Allan Conway ◽  
Eileen Lu ◽  
Nhan Nguyen Tran ◽  
Gary Giangola ◽  
...  
Keyword(s):  
Connective Tissue ◽  
Thoracic Endovascular Aortic Repair ◽  
Endovascular Aortic Repair ◽  
Acute Type ◽  
Type B ◽  
Connective Tissue Disorders ◽  
Aortic Repair ◽  
Type B Dissection ◽  
Significant Difference

Objectives: Thoracic endovascular aortic repair (TEVAR) remains controversial in patients with connective tissue disorders given the concern for durability. We report on the largest series to date on outcomes of patients with thoracic aortic disease and connective tissue disorders treated with TEVAR. Methods: The Vascular Quality Initiative registry identified 12 207 patients treated with TEVAR from January 2010 to December 2018, including 102 with Marfans, Ehlers-Danlos, or Loey-Dietz syndrome. Outcomes were analyzed per the Society for Vascular Surgery reporting standards. Results: Median age was 50.6 years (interquartile range: 57.0-75.0), and 62 (60.7%) were male. Eighty-eight (86.3%) patients had Marfan, 9 (8.8%) had Ehlers-Danlos, and 5 (4.9%) had Loey-Dietz syndrome. Twenty-six (25.5%) patients were treated for degenerative aneurysmal disease and 76 (74.5%) patients for type B dissections (33 acute, 31 chronic). Most common indications for interventions in patients with type B dissection were pain (n = 41), aneurysmal degeneration (n = 16), and malperfusion (n = 8), with 3 patients who presented ruptured. There was no significant difference in perioperative complications between acute/chronic dissections and aneurysms ( P = .14). Percutaneous access was utilized in 61.7% of patients, with a 2.9% rate of arterial injury requiring reintervention. Follow-up data were available for 75 (73.3%) patients at a mean follow-up of 15.6 months. Overall mortality was 5.3%. There were 30 patients with follow-up endoleak data, and 8 (26.7%) endoleaks were identified. All endoleaks were in patients treated for acute type B dissection, and all resolved after a mean of 2.1 reinterventions. Three patients treated for acute Type B Aortic Dissection (TBAD) had retrograde dissections requiring intervention. Discussion: Thoracic endovascular aortic repair for patients with connective tissue disorders can be performed with low perioperative mortality, spinal cord ischemia, or Cerebrovascular Accident (CVA). On follow-up, acute type B aortic dissections represent a higher risk subgroup with increased rates of endoleak and retrograde dissection. Closer follow-up for these patients and early reintervention may be beneficial.

scholarly journals Implications of Secondary Aortic Intervention After Thoracic Endovascular Aortic Repair for Acute and Chronic Type B Dissection

2018 ◽  
Vol 67 (1) ◽  
pp. e7-e8
Author(s):  
Salvatore T. Scali ◽  
Kristina A. Giles ◽  
Salim Lala ◽  
Suzannah Patterson ◽  
Martin Back ◽  
...  
Keyword(s):  
Thoracic Endovascular Aortic Repair ◽  
Endovascular Aortic Repair ◽  
Type B ◽  
Chronic Type ◽  
Aortic Repair ◽  
Type B Dissection

scholarly journals Retrograde Type A Aortic Dissection after Thoracic Endovascular Aortic Repair for Type B Dissection

2020 ◽  
Vol 23 (4) ◽  
pp. E524-E526
Author(s):  
Masato Hayakawa ◽  
Takaaki Nagano ◽  
Isao Nishijima ◽  
Kento Shinzato ◽  
Ryo Ikemura ◽  
...  
Keyword(s):  
Aortic Dissection ◽  
Aortic Arch ◽  
Type A ◽  
Thoracic Endovascular Aortic Repair ◽  
Endovascular Aortic Repair ◽  
Type B ◽  
Entry Site ◽  
Type A Aortic Dissection ◽  
Aortic Repair ◽  
Type B Dissection

Background: A 64-year-old woman presented with dilatation of the distal aortic arch secondary to chronic type B aortic dissection. Case Report: The patient underwent fenestrated thoracic endovascular aortic repair (TEVAR) for closure of the entry site, and reconstruction of the left subclavian artery with a covered stent. On the 40th postoperative day, a retrograde type A aortic dissection (RTAD) was observed on computed tomography and she underwent emergency surgery. The entry tear, related to the proximal bare metal stent, was located in front of the aortic arch. A partial aortic arch replacement was performed. Conclusion: Consideration of the risk factors of RTAD is important when performing TEVAR.

scholarly journals Outcomes of single physician-modified fenestrated stent grafts for endovascular repair of thoracic aortic lesions involving the distal aortic arch

2020 ◽  
Author(s):  
Jiechang Zhu ◽  
Chao Ma ◽  
Xiangchen Dai ◽  
Zheng Wang ◽  
Hailun Fan ◽  
...  
Keyword(s):  
Aortic Arch ◽  
Thoracic Endovascular Aortic Repair ◽  
Endovascular Aortic Repair ◽  
Acute Type ◽  
Type B ◽  
Stent Grafts ◽  
Aortic Repair ◽  
Type B Dissection ◽  
Aortic Pathologies ◽  
Aortic Lesions

Abstract OBJECTIVES Our goal was to evaluate the outcomes of fenestrated thoracic endovascular aortic repair of thoracic aortic lesions involving the distal aortic arch using single physician-modified stent grafts. METHODS This single-centre, retrospective study included 58 consecutive patients (mean age, 57 ± 14 years; 11 women) who underwent fenestrated thoracic endovascular aortic repair for thoracic aortic pathologies involving the distal aortic arch using single physician-modified stent grafts between November 2015 and December 2018. Indications included complicated acute type B dissection or intramural haematoma with an unfavourable proximal landing zone (n = 49), type Ia endoleak subsequent to thoracic endovascular aortic repair due to acute type B dissection (n = 1) and distal arch degenerative aneurysms <15 mm from the left subclavian artery (n = 8). RESULTS The technical success rate was 94.8%. The 30-day mortality was 1.7%, and the perioperative ischaemic stroke rate was 1.7%. The incidence of perioperative complications was 10.3%. At a mean follow-up of 26.3 months (range, 7–44), all target vessels were patent. All-cause mortality was 5.2%. Estimated 1-, 2- and 3-year survival was 98.3 ± 1.7%, 96.4 ± 2.5% and 93.2 ± 3.9%, respectively. CONCLUSION The single fenestrated stent graft technique is feasible and effective for endovascular repair of thoracic aortic pathologies involving the distal aortic arch.

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