Relevance of Aortic Dissection Chronicity to the Development of Stent Graft-induced New Entry.

Abstract

BACKGROUND:

The relevance of aortic dissection chronicity to the development of stent graft-induced new entry (SINE) is unknown.

METHODS:

This study enrolled 69 patients who underwent thoracic endovascular aortic repair (TEVAR) for chronic aortic dissection from January 2006 to December 2017 and were followed up for ≥6 months. Their medical records were reviewed retrospectively. Patients were stratified according to TEVAR timing into an early group (≤6 months from the onset of aortic dissection) and a late group (>6 months after the onset). The incidence of SINE as well as the interval between TEVAR and the development of SINE was compared between these groups.

RESULTS:

During the follow-up period, SINE occurred in 12% (3/26) and 35% (15/43) of patients in the early and late groups, respectively (P = .029). The interval between TEVAR and SINE development was significantly longer in the late group than the early group (median, 92 days vs 1144 days, respectively; P = .002). According to the multivariate analysis results, the late group (hazard ratio, 3.667; 95% confidence interval, 1.037-12.968; P = .044) and the distal oversizing ratio (hazard ratio, 1.492; 95% confidence interval, 1.071-2.080; P = .018) were the independent predictors for SINE development.

CONCLUSIONS:

TEVAR should be performed in the early period of the chronic phase to prevent SINE. Close and lifelong follow-up is mandatory for patients who undergo TEVAR >6 months after onset because SINE can develop several years after TEVAR in those patients.

• Authors: Takafumi Ouchi, Noriyuki Kato, Hiroaki Kato, Takatoshi Higashigawa, Hisato Ito, Ken Nakajima, Shuji Chino, Toshiya Tokui, Toru Mizumoto, Hajime Sakuma
• Journal: The Annals of thoracic surgery (Ann Thorac Surg) Vol. 110 Issue 6 Pg. 1983-1989 (12 2020) ISSN: 1552-6259 [Electronic] Netherlands
• PMID: 32479754 (Publication Type: Journal Article)
• Copyright: Copyright © 2020 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Topics

• Aged
• Aortic Dissection (complications, surgery)
• Aortic Aneurysm, Thoracic (complications, surgery)
• Blood Vessel Prosthesis (adverse effects)
• Blood Vessel Prosthesis Implantation (adverse effects)
• Chronic Disease
• Endovascular Procedures (adverse effects)
• Female
• Humans
• Male
• Middle Aged
• Postoperative Complications (epidemiology)
• Prosthesis Design
• Retrospective Studies
• Stents (adverse effects)
• Time Factors