December 10, 2019Annals of Vascular DiseasesOpen Access

Total arch replacement using a frozen elephant trunk for acute exacerbation of type B aortic dissection significantly reduced false lumen diameter from 16.4 mm to 5.9 mm, with 0% early mortality and no spinal cord injuries.

Q: What is the clinical evidence from this study?

Study design: Cohort. Population: Acute type B aortic dissection (n=142). Intervention: Total arch replacement using frozen elephant trunk (TAR-FET) vs. Preoperative baseline. Primary outcome: False lumen diameter (mm) (p=<0.001).

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Why the study?

The timing and choice of surgical method for type B aortic dissection remain a topic of much debate.

Does total arch replacement using frozen elephant trunk (TAR-FET) prevent distant aortic events and improve survival in patients with acute type B aortic dissection requiring surgery?

Population

142 patients with acute type B dissection

Comparison

TAR-FET for surgical intervention

Design

Cohort study

Follow-up

5 years

Key result

Total arch replacement using a frozen elephant trunk for acute exacerbation of type B aortic dissection significantly reduced false lumen diameter from 16.4 mm to 5.9 mm, with 0% early mortality and no spinal cord injuries.

Authors

YMYuichi Matsuzaki TYTakuma Yamasaki YHYu Hohri

Discussion

Member takes

Overview

May support selective TAR-FET in complicated type B dissection; leaves open need for randomized trials versus TEVAR.

Study Design

Type

Cohort (n=142)

Multicenter

Structured PICO

Does total arch replacement using frozen elephant trunk (TAR-FET) prevent distant aortic events and improve survival in patients with acute type B aortic dissection requiring surgery?

Population

142 patients with acute type B aortic dissection, of whom 33 underwent surgical intervention (17 TAR-FET, 16 TEVAR) for acute exacerbation, followed for a mean of 15.8 months.

Intervention

Total arch replacement using frozen elephant trunk (TAR-FET) performed at a mean of 42±26 days from symptom onset.

Outcome

Aortic event-free survival at 5 years, false lumen reduction ratio, and complications (retrograde type A aortic dissection [RTAD] or paraplegia).hard clinical

Main Result

Absolute Event Rate: 5.9% vs 16.4%

p-value: p=<0.001

Total arch replacement using frozen elephant trunk (TAR-FET) is a viable and safe surgical strategy for type B aortic dissection, yielding excellent 5-year event-free survival without severe complications like RTAD or paraplegia.

Limitations

Retrospective, single-center study design
Small sample size of patients undergoing surgical intervention
Non-randomized comparison with significant baseline differences between the TAR-FET and TEVAR groups
Relatively short mean follow-up period of 15.8 months

Cite This Study

Matsuzaki et al. (2019) conducted a cohort in Acute type B aortic dissection (n=142). Total arch replacement using frozen elephant trunk (TAR-FET) vs. Preoperative baseline was evaluated on False lumen diameter (mm) (p=<0.001). Total arch replacement using a frozen elephant trunk for acute exacerbation of type B aortic dissection significantly reduced false lumen diameter from 16.4 mm to 5.9 mm, with 0% early mortality and no spinal cord injuries.

synapsesocial.com/papers/6a97cbdace42e14121e1789e https://doi.org/10.3400/avd.oa.19-00094

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December 10, 2019Annals of Vascular DiseasesOpen Access

Total arch replacement using a frozen elephant trunk for acute exacerbation of type B aortic dissection significantly reduced false lumen diameter from 16.4 mm to 5.9 mm, with 0% early mortality and no spinal cord injuries.

View Full Paper

Ask AI

Bookmark

Why the study?

The timing and choice of surgical method for type B aortic dissection remain a topic of much debate.

Does total arch replacement using frozen elephant trunk (TAR-FET) prevent distant aortic events and improve survival in patients with acute type B aortic dissection requiring surgery?

Population

142 patients with acute type B dissection

Comparison

TAR-FET for surgical intervention

Design

Cohort study

Follow-up

5 years

Key result

Authors

YMYuichi Matsuzaki TYTakuma Yamasaki YHYu Hohri

Discussion

Member takes

Overview

May support selective TAR-FET in complicated type B dissection; leaves open need for randomized trials versus TEVAR.

Study Design

Type

Cohort (n=142)

Multicenter

Structured PICO

Does total arch replacement using frozen elephant trunk (TAR-FET) prevent distant aortic events and improve survival in patients with acute type B aortic dissection requiring surgery?

Population

142 patients with acute type B aortic dissection, of whom 33 underwent surgical intervention (17 TAR-FET, 16 TEVAR) for acute exacerbation, followed for a mean of 15.8 months.

Intervention

Total arch replacement using frozen elephant trunk (TAR-FET) performed at a mean of 42±26 days from symptom onset.

Outcome

Aortic event-free survival at 5 years, false lumen reduction ratio, and complications (retrograde type A aortic dissection [RTAD] or paraplegia).hard clinical

Main Result

Absolute Event Rate: 5.9% vs 16.4%

p-value: p=<0.001

Limitations

Retrospective, single-center study design
Small sample size of patients undergoing surgical intervention
Non-randomized comparison with significant baseline differences between the TAR-FET and TEVAR groups
Relatively short mean follow-up period of 15.8 months

Cite This Study

synapsesocial.com/papers/6a97cbdace42e14121e1789e https://doi.org/10.3400/avd.oa.19-00094

Also Consider

Synapse has enriched 3 closely related papers on similar clinical questions. Consider them for comparative context:

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