Key result
A larger preprocedure maximum false lumen area was an independent predictor of failed false lumen volume reduction after TEVAR in type B aortic dissection (OR 1.3; 95% CI 1.02-1.70; P=0.031).
Why the study?
Does maximum preprocedure false lumen area predict failed false lumen volume reduction at 12 months in patients with type B aortic dissection undergoing TEVAR?
Cohort (n=38)
Does maximum preprocedure false lumen area predict failed false lumen volume reduction at 12 months in patients with type B aortic dissection undergoing TEVAR?
Odds Ratio: 1.3 (95% CI 1.02–1.7)
p-value: p=0.031
A larger preprocedure maximum false lumen area predicts failure of false lumen volume reduction after TEVAR, which is associated with significantly higher rates of mortality or reintervention.
May aid risk stratification by preprocedure false lumen area in type B dissection TEVAR; leaves open prospective validation before guiding decisions.
PURPOSE: To investigate the predictors of failed false lumen (FL) volume reduction at 12 months after stent-graft implantation in patients with type B aortic dissection. METHODS: The retrospective analysis comprised 38 patients (25 men; mean age 60±12 years) with double-barrel type B aortic dissection (9 acute) treated with thoracic endovascular aortic repair (TEVAR) and evaluated with serial computed tomography (CT) scans up to 12 months. Aortic volume changes were determined. Based on FL volume change at 1 year after stent-graft implantation, patients were dichotomized according to the presence or absence of FL volume reduction. Clinical and CT variables were compared between groups to determine risk factors of failed FL volume reduction. A major adverse event (MAE) was defined as death or reintervention. RESULTS: Patients were followed for 4.2±2.8 years. FL volume reduction (+FLVR) occurred in 27 (71%) patients, whereas 11 (29%) patients had no FL volume reduction (-FLVR). The MAE-free survival rate was significantly higher in the +FLVR patients than in the -FLVR group (88.9% vs. 27.3%, respectively; p=0.001). Chronicity of dissection, location of tear site, or the maximum total aortic lumen area was not associated with failure to achieve FL volume reduction. However, the maximum preprocedure FL area was significantly lower in the +FLVR group than in the -FLVR group (12.6±6.6 vs. 21.0±11.4 cm(2), respectively; p=0.041) and was an independent predictor for failed FL volume reduction (odds ratio 1.3, 95% confidence interval 1.02 to 1.70, p=0.031). CONCLUSION: Failed FL volume reduction after TEVAR was associated with a significantly increased rate of mortality or reintervention during follow-up. A larger preprocedure maximum FL area was a predictor of failed FL volume reduction after TEVAR in type B dissection.
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Kim et al. (2014) conducted a cohort in Type B aortic dissection (n=38). Maximum preprocedure false lumen area was evaluated on Failed false lumen volume reduction at 1 year (OR 1.3, 95% CI 1.02-1.70, p=0.031). A larger preprocedure maximum false lumen area was an independent predictor of failed false lumen volume reduction after TEVAR in type B aortic dissection (OR 1.3; 95% CI 1.02-1.70; P=0.031).
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