Objective: A review of the literature was conducted for incidence, outcomes, and risk factors for distal stent graft-induced new entry (SINE) after thoracic endovascular aortic repair (TEVAR) of aortic dissection.
Methods: The review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.
Results: Seven articles reporting on 1415 patients with thoracic aortic dissection undergoing TEVAR without supplemental distal bare stenting were included. In this cohort, 86 patients were treated for a residual type A aortic dissection and 1329 for a complicated type B aortic dissection. Distal SINE occurred in 112 patients (7.9%). The mean time to identification of distal SINE was 19 ± 7 months. The incidence of distal SINE after TEVAR for type B aortic dissection differed on the basis of whether it was a chronic or acute dissection repair and was, respectively, 12.9% (43/331) and 4.3% (12/273). Successful secondary interventions were performed in 54% of the patients. All the studies analyzing the relationship between distal stent graft oversizing and incidence of distal SINE reported a significantly higher rate of SINE with oversizing.
Conclusions: The successful management of complicated descending thoracic aortic dissections by TEVAR is well established. Whereas distal SINE is relatively frequent, if it does occur, the complication can generally be treated with additional TEVAR without a poor outcome. The main determinant of SINE seems to be excessive distal oversizing.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.jvs.2018.07.086 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Enhanced recovery in type A aortic dissection evaluating the efficacy and feasibility of early myocardial reperfusion.
Front Cardiovasc Med
January 2025
Department of Cardiovascular Surgery, General Hospital of Northern Theater Command, Shenyang, China.
Background: This study investigates the feasibility and early outcomes of early myocardial reperfusion in patients with type A aortic dissection (TAAD), evaluating its effectiveness and potential benefits compared to traditional cardioplegic arrest techniques.
Methods: A retrospective analysis was conducted on 168 patients diagnosed with TAAD who underwent surgery at the General Hospital of the Northern Theater Command in China from January 2021 to July 2024. Patients were divided into two groups: early myocardial reperfusion (EMR group, = 66) and cardioplegic arrest (CA group, = 102).
CT angiography of acute aortic syndrome in patients with chronic kidney disease.
Int J Cardiovasc Imaging
January 2025
Department of Clinical Radiology, AHEPA University Hospital of Thessaloniki, Aristotle University of Thessaloniki, Thessaloniki, Greece.
The term acute aortic syndrome (AAS) refers to a range of different entities, including dissection, intramural haematoma and penetrating atherosclerotic ulcer. Patients with chronic renal disease and particularly those with dominant polycystic kidney disease are susceptible to this pathology, given the underlying renal arteriopathy and hypertension. Imaging plays a crucial role in diagnosing, grading and guiding management of these patients, with computed tomography angiography (CTA) being on the frontline.
View Article and Find Full Text PDFMalperfusion in Patients with Acute Type A Aortic Dissection: A Nationwide Analysis.
Ann Thorac Surg
January 2025
Division of Cardiovascular Surgery, University of Pennsylvania, Philadelphia, PA; Leonard Davis Institute, University of Pennsylvania, Philadelphia, PA; Penn Cardiovascular Outcomes, Quality, & Evaluative Research Center, Philadelphia, PA.
Background: This study describes in detail the clinical burden of malperfusion associated with acute Type A aortic dissection (ATAAD) in a large, national cohort and the effect of treatment strategy on outcomes.
Methods: All patients undergoing repair of ATAAD between 2017 and 2020 in the Society of Thoracic Surgeons (STS) Adult Cardiac Surgery Database were studied. Malperfusion was defined using STS definitions based on imaging or surgeon's evaluation.
Cocaine and aortic dissection: the need for collaboration to overcome the underreporting bias.
Forensic Sci Med Pathol
January 2025
Department of Advanced Biomedical Sciences, School of Medicine, University of Naples Federico II, Via S. Pansini, 5, Naples, 80131, Italy.
The dissection of the aorta is a serious and potentially fatal consequence of cocaine use. Nonetheless, the underlying mechanisms and characteristics of this phenomenon remain to be deeply studied. The autopsy case of a 46-year-old white male found irresponsive and unconscious in his house and had a history of abusing cocaine is presented.
View Article and Find Full Text PDFBackground: Apolipoprotein C3 (apo C3) is primarily secreted by the liver and is involved in promoting sterile inflammation and organ damage under pathological conditions. Previous studies have shown that apo C3 is abundant in the plasma exosomes of patients with aortic dissection (AD), but its specific role in AD remains unclear.
Methods And Results: In vivo, adeno-associated virus was used to knock down hepatic apo C3 expression in an AD mouse model to assess the impact of liver-derived apo C3 on the development of AD.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!