Midterm Results Of Endovascular Entry Closure For Type B Aortic Dissection
Atsushi Omura, Hitoshi Matsuda, Jiro Matsuo, Naoki Tadokoro, Yosuke Inoue, Yoshimasa Seike, Kyokun Uehara, Hiroaki Sasaki, Junjiro Kobayashi.
National Cerebral and Cardiovascular Center, Suita, Osaka, Japan.
OBJECTIVE: Entry closure using endovascular technique has increasingly been applied in type B aortic dissection. However, the long-term outcomes of this approach have not been determined. We analyzed the midterm results of endovascular entry closure for aortic type B dissection.
METHODS: From 2008 to 2013, 17 patients underwent the entry closure using the endovascular technique. Mean age was 69±9 years old. We performed 4 operations under emergent situations (organ malperfusion 1 and rupture 3). In 13 elective cases, the mean and median operation day from the onset of type B aortic dissection was 94 days and 50 day, respectively.
RESULTS: Technical success was obtained in all cases. Five patients required the revascularization of left subclavian artery. Zone 2, 3, and 4 landing were 5, 7, and 5 cases, respectively. Mean operation time was 139±83 minutes. Used endoprosthesis was 13 Gore TAG and 4 Zenith TX2. A 79 year-old patients with chronic lung disease and renal failure was dead due to multi-organ failure 3 months after the surgery. During follow-up period 35±27 months, there were 2 late death (sudden death and senility). Survival rate at 3 years were 87.1±8.6%. Computed tomography at 3 years after surgery was performed in 11 patients (64.7%). All these patients had the regression of false lumen and whole aortic diameter at the site of stent-graft deployment. And also, there was no endovascular related complication (infection, aortic dissection at proximal or distal landing zone).
CONCLUSIONS: We obtained the favorable midterm results after the entry closure using the endovascular technique for type B aortic dissection. However, we need the longer follow-up period.
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