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Endovascular stent‐grafts treatment in acute aortic dissection (type B): Clinical outcomes during early, late, or chronic phases
Author(s) -
Chen Shaoliang,
Yei Fei,
Zhou Ling,
Luo Jun,
Zhang Junjie,
Shan Shoujie,
Tian Nailiang,
Kwan Tak W.
Publication year - 2006
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.20821
Subject(s) - medicine , stent , surgery , aortic dissection , creatinine , radiology , contrast induced nephropathy , cardiology , aorta , myocardial infarction , percutaneous coronary intervention
Objective : This is a prospective study to evaluate the clinical outcomes of endovascular repair in patients with different phases of type B aortic dissection. Background : Endovascular repairing with stent‐grafts is an innovative technique for type B acute aortic dissection. There is no previous study regarding outcomes in different time phases. Methods : Sixty‐two patients underwent endovascular stent‐grafts. There were 23 in the early phase (<24 hr), 20 in the late phase (≥24 hr to 2 weeks), and 19 in the chronic phase (>2 weeks). Results : The early phase group had the lowest ratio of stent‐grafts to patient and the shortest stent‐graft length. The chronic phase group had the largest diameter of false lumen. The technical success rate was 100%; no patient died within hospital. Three patients died within 30 days, with the same death rate in every group. Compared with acute patients, the chronic group had a higher volume of contrast, a higher creatinine post‐procedure, and a higher incidence of contrast‐induced nephropathy. Multiple regression analysis demonstrated that creatinine and endoleak were independent factors in predicting late death (95% CI, 3.4–26%, P < 0.01). The overall cardiovascular event‐free survival was 88.9% ± 2.1% at 30 days, 87.2% ± 4.1% at 1 year, and 81.4% ± 6.3% at 2 years. CT angiography identified the complete or partial thrombosis of the false lumen to be 95.7%. Conclusions : Endovascular repairing with stent‐graft is safe, feasible, and able to treat type B aortic dissection in all phases. However, chronic renal dysfunction was an independent factor which contributed to a lower survival rate of chronic phase patients. © 2006 Wiley‐Liss, Inc.