Procedure and Aortic Remodeling Effects of Entry Closure with Stentgraft for Type B Aortic Dissection: Comparison between the Patients with Narrow True Lumen and Those with Aneurysmal Dilated False Lumen

Figures

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  Fig. 1 Serial change of oversizing at the distal end of stentgraft. In narrow group, distal oversizing became significantly smaller 1 week after TEVAR and continued to become small until 1 year after TEVAR. In aneurysmal group, distal oversizing did not become small 7 days after TEVAR, then became small 6 months or 1 year after TEVAR. Distal oversizing was significantly larger in narrow group pre-TEVAR, however it became significantly smaller in narrow group 1 week after and 1 year after TEVAR.

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  Fig. 2 Disappearance of false lumen at the end of stentgraft. False lumen at the end of stentgraft disappeared significantly earlier and in more patients in narrow group.

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  Fig. 3 Achievement of aortic remodeling. Aortic remodeling defined as true lumen diameter ≥50% of aortic diameter and closure of false lumen was significantly better in narrow group.

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  Fig. 4 Angiogram during stentgraft deployment of the patient with stentgraft migration in narrow group. Left panel: In this patient, primary entry existed just beneath the left subclavian artery and location of primary entry was posterior aspect of the aorta. CTAG active control was deployed just distal to the left subclavian artery. Proximal edge of stentgraft seemed to be oval shape as shown with white triangle. Right panel: In this patient, aortic diameter enlarged 6 mm three months after TEVAR, and GTAG active control was implanted just distal to the left carotid artery. At this time, proximal edge of stentgraft was visualized as perpendicular view at the half deployment. Proximal edge of stentgraft became straight line by final angiogram as shown with white triangle.

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  Fig. 5 Aortic event free rate. Dissection related death, retrograde Type A dissection, stentgraft induced new entry and aortic expansion 5 mm or more were defined as aortic event. Aortic event free rate was significantly better in narrow group.