Document Detail

Endovascular repair or medical treatment of acute type B aortic dissection? A comparison.
MedLine Citation:
PMID:  18996662     Owner:  NLM     Status:  MEDLINE    
INTRODUCTION: The aim of this retrospective study was to compare the outcome of thoracic endovascular aortic repair (TEVAR) to that of medical therapy in patients with acute type B aortic dissection (TBD). MATERIALS AND METHODS: From July 1996 to April 2008, 88 patients presenting with acute TBD underwent either TEVAR (group A, n=38) or medical therapy (group B, n=50). Indications for TEVAR were intractable pain, aortic branch compromise resulting in end-organ ischemia, rapid aortic dilatation and rupture. Follow-up was performed postinterventionally, at 3, 6 and 12 months and yearly thereafter and included clinical examinations and computed tomography (CT), as well as aortic diameter measurements and assessment of thrombosis. RESULTS: Mean follow-up was 33 months in group A and 36 months in group B. The overall mortality rate was 23.7% in group A and 24% in group B, where 4 patients died of late aortic rupture. In group A, complications included 9 endoleaks and 4 retrograde type A dissections, 3 patients were converted to open surgery and 2 needed secondary intervention. None of the patients developed paraplegia. In group B, 4 patients were converted to open surgery and 2 to TEVAR. The maximal aortic diameter increased in both groups. Regarding the extent of thrombosis, our analyses showed slightly better overall results after TEVAR, but they also showed a tendency towards approximation between the two groups during follow-up. CONCLUSION: TEVAR is a feasible treatment option in acute TBD. However, several serious complications may occur during and after TEVAR and it should therefore be reserved to patients with life-threatening symptoms.
I Chemelli-Steingruber; A Chemelli; A Strasak; B Hugl; R Hiemetzberger; W Jaschke; B Glodny; B V Czermak
Publication Detail:
Type:  Comparative Study; Controlled Clinical Trial; Journal Article     Date:  2008-11-08
Journal Detail:
Title:  European journal of radiology     Volume:  73     ISSN:  1872-7727     ISO Abbreviation:  Eur J Radiol     Publication Date:  2010 Jan 
Date Detail:
Created Date:  2010-02-01     Completed Date:  2010-04-14     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8106411     Medline TA:  Eur J Radiol     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  175-80     Citation Subset:  IM    
Copyright Information:
Copyright (c) 2009 Elsevier Ireland Ltd. All rights reserved.
Department of Radiology, Innsbruck Medical University, Austria.
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MeSH Terms
Aged, 80 and over
Aneurysm, Dissecting / diagnosis,  therapy*
Aortic Aneurysm / diagnosis,  therapy*
Blood Vessel Prosthesis*
Fibrinolytic Agents / administration & dosage*
Middle Aged
Vascular Surgical Procedures / methods*
Reg. No./Substance:
0/Fibrinolytic Agents

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