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• W2012014907 abstract "Evidence is accumulating surrounding endovascular treatment of acute type B dissections. Controversy surrounds endograft repair of chronic type B dissections (CTBD) mainly because of the concern of not being able to exclude the entire false lumen (FL) secondary to multiple reentry points. There are reports of successful treatments but treatment goals and criteria for success have not been defined. We aim to define the objectives and criteria for successful endograft treatment of CTBDs. Retrospective record review of all patients undergoing elective thoracic endovascular aortic repair (TEVAR) at our institution for treatment of CTBD was performed. The patients were followed up in the aortic disease clinic. Postoperative computed tomography angiograms were performed at 1, 6, and 12 months and yearly thereafter. Between June 2008 and December 2009, 24 TEVARs were performed to treat CTBDs with aneurysmal degeneration. Patients were a mean age of was 54 years (range, 42-68 years). The mean aortic diameter at the treatment zone was 5.8 cm (range, 4.8-6.2 cm). One patient (4%) had a type Ia endoleak that was treated successfully with a proximal extension. One patient (4%) was treated with a surgeon-modified abdominal and arch fenestrated endograft. There were no deaths, no strokes, or paralysis. All intended treatment zones showed evidence of thrombosis. There was no instance of complete thrombosis and remodeling of the entire FL. The mean follow-up period was 16 months (range, 12-28 months). There was one (4%) secondary intervention after the immediate postoperative period. There were no instances of rupture or growth of the intended treatment area during the follow-up period. In our cohort, although the entire FL did not thrombose and remodel, the intended treatment zone in all patients thrombosed and there was no further growth. The success of TEVAR for CTBDs should be viewed in terms of the intended treatment zone. Careful patient selection and review and identification of all re-entry points increase the likelihood of success. Although the follow-up in this study is short, the results are encouraging. Long-term data and follow-up will shed more light into the utility of this exciting treatment modality." @default.
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• W2012014907 date "2012-10-01" @default.
• W2012014907 modified "2023-10-05" @default.
• W2012014907 title "Thoracic Endovascular Aortic Repair for Chronic Type B Dissection: How to Define Treatment Success" @default.
• W2012014907 doi "https://doi.org/10.1016/j.jvs.2012.08.032" @default.
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