Abstract 19974: Long Term Outcome after Endovascular Repair of Complicated Acute and Chronic Type B Dissection
Background: The optimal treatment for patients with type B aortic dissection (AD) remains a matter of debate. Stent-graft placement, one of the treatment strategies of type B-AD, is feasible with high technical success rate and low mortality rate. However, there is paucity of data about long term outcomes of endovascular repair in patients with complicated acute & chronic type B-AD. The aim of this study was to evaluate the long term outcome of thoracic endovascular aortic repair (TEVAR) in these patients.
Method: A total of 84 patients (69% male, mean age 56 ± 13 years) who were diagnosed with complicated acute&chronic type B-AD (18 with complicated acute type B-AD, 66 with chronic type B-AD) and underwent endovascular stent-graft repair from 1994 to 2009 at Severance Hospital were enrolled. The separate type (modular) stent-graft (S&G Biotech Inc., Seongnam, Korea) was used for deployment in these patients. Primary endpoint was defined as all-cause mortality, and secondary endpoint was defined as composite of all-cause mortality, re-intervention, conversion to open surgery, and graft failure. Survival analysis was done by using Kaplan-Meier method.
Result: Procedural success was obtained in 98% (82/84). There were 21 peri-procedural type 1 endoleak (21/82 26%) and 2 major peri-procedural complications in successful treatment group (2/82, 2%)(1 peri-procedural mortality, 1 peri-procedural stroke). Mean follow-up period was 5.0 ± 3.5 years. During the follow-up, survival rate of all-cause mortality was 93% (75/81), and event-free survival rate was 67% (54/81).
Conclusion: The efficacy of TEVAR as treatment strategy of complicated acute&chronic type B-AD is accentuated by excellent long term survival rate, irrespective of late complication rates. Figure 1. Outcomes of TEVAR using Kaplan-Meier curves. (a) Survival curve of all-cause mortality, (b) Event-free survival curve including all-cause mortality, re-intervention, surgical conversion, and graft failure
- © 2010 by American Heart Association, Inc.