Experience with thoracic endovascular aortic repairapplied in treating Stanford type B aortic dissection:An analysis of 98 cases

BACKGROUND: Thoracic endovascular aortic repair (TEVAR) has been frequently applied in Stanford type B aortic dissection since thoracic aortic diseases were first treated with artificial vessels. OBJECTIVES: The aim of this study was to analyze the clinical value of TEVAR applied in treating Stanford type B aortic dissection. MATERIAL AND METHODS: Between January 2007 and April 2014, 167 consecutive Stanford type B aortic dissection patients were treated with TEVAR and retrospectively analyzed. RESULTS: All patients had a successful operation. A total of 98 patients were followed-up and the duration of the follow-up ranged from 3 to 63 months with a mean of 25.6 ±8.4 months. Proximal type I endoleak occurred in 18 patients with an incidence rate of 18.37% and a cuff was deployed in 7 patients, in whom the endoleak disappeared after 3 months. Two patients died in the perioperative period: one died from aortic dissection rupture, while the other died from infectious shock. One patient died from acute myocardial infarction during the follow-up period. Tears occurred in the end piece of stent grafts in 12 patients, and additional TEVAR was performed. One patient had a proximal retrograde type A dissection; the patient was in an acceptable state of health apart from persistent chest and back pain, and is still in follow-up. Spinal cord ischemia, stent displacement and collapse did not occur. CONCLUSIONS: TEVAR is reliable and safe, and it can be widely applied in treating Stanford type B aortic dissection.