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Potential risk factors of re‐intervention after endovascular repair for type B aortic dissections
Author(s) -
Zhang Lei,
Zhou Jian,
Lu Qingsheng,
Zhao Zhiqing,
Bao Junmin,
Jing Zaiping
Publication year - 2015
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.25733
Subject(s) - medicine , aortic repair , intervention (counseling) , cardiology , surgery , aorta , nursing
Objectives To assess the potential risk factors of re‐intervention after thoracic endovascular aortic repair (TEVAR). Background TEVAR has been chosen as a less invasive alternative for Type B aortic dissections (TBADs); however, the potential risk factors of re‐intervention remain unclear. Methods : A total of 252 TBADs patients initially treated with TEVAR between September 1998 and July 2012 were retrospectively reviewed. The indications for the initial TEVAR were 32 aorta enlargement (24 chronic), 71 malperfusion, 46 rupture (32 chronic), 67 refractory pain (54 chronic), and 44 refractory hypertension (38 chronic). The patients were stratified into single‐intervention group and multi‐intervention group. Results The mean age was 54.1 years with 81.7% of male. We found the time from symptom onset to TEVAR was longer in multi‐intervention group (17 vs. 112.5 days, P = 0.006). Higher proportions of chronic dissection and smoking occurred in multi‐intervention group (53.9% vs. 79.2% and 43.9% vs. 70.8%, P = 0.018 and 0.012, respectively). The differences of oversizing, operation time, contrast medium dose, and blood loss between the groups were significant (13.8 ± 2.4% vs. 16.4 ± 2.9%, 92.5 vs. 196 minutes, 110 vs. 210 ml, 100 vs. 300 ml; P < 0.001, <0.001, =0.002, and =0.003, respectively). The mortality within 30 days was 2.4% and the rates of stoke, paraplegia and retrograde dissection were 3.6%, 5.6% and 0.8%, respectively. The most common reasons of re‐intervention were endoleaks, new dissections and incomplete thrombosis of the false lumen. Conclusions we concluded that chronic phase, smoking and too big oversizing were potential risk factors of re‐intervention. © 2014 Wiley Periodicals, Inc.