Management and Outcomes of Non-A Non-B Aortic Dissection. (November 2022)
- Record Type:
- Journal Article
- Title:
- Management and Outcomes of Non-A Non-B Aortic Dissection. (November 2022)
- Main Title:
- Management and Outcomes of Non-A Non-B Aortic Dissection
- Authors:
- Liu, Jitao
Yang, Fan
Chen, Lyufan
Xie, Enmin
Su, Sheng
Liu, Yuan
Geng, Qingshan
Fan, Ruixin
Li, Jie
Luo, Jianfang - Abstract:
- Abstract : Objective: The results of best medical treatment (BMT), endovascular based treatment (EBT), and total arch replacement (TAR) with frozen elephant trunk (FET) treatment in a single centre experience were reported in non-A non-B aortic dissection patients. Methods: From January 2016 to May 2020, 215 consecutive patients with acute or subacute non-A non-B aortic dissection were enrolled. The primary endpoints were all cause death. Secondary endpoints included follow up adverse aortic event (AE), a composite of the outcomes of dissection related death, rupture, retrograde type A aortic dissection, stent graft induced new entry tear, secondary endoleak, and follow up re-intervention. Kaplan–Meier curves were used to evaluate associations between different treatments and outcomes. Results: Among the 215 dissection patients, 127 (59.1%) received EBT, 42 (19.5%) received TAR + FET, and the remaining 46 (21.4%) received BMT. Thirty day mortality was higher in patients receiving TAR + FET (7.1%) than in those treated with EBT (1.6%) or BMT (2.2%) ( p = .12). However, after a median follow up of 39.1 (27.0 – 50.7) months, no additional death was recorded in the TAR + FET group, while nine (7.3%) patients died in the EBT group and 14 (31.8%) died in the BMT group ( p < .001). Specifically, EBT and TAR + FET showed no significant difference in midterm mortality rate, follow up AE, and re-intervention for complicated or uncomplicated dissection patients involving zone 2. ForAbstract : Objective: The results of best medical treatment (BMT), endovascular based treatment (EBT), and total arch replacement (TAR) with frozen elephant trunk (FET) treatment in a single centre experience were reported in non-A non-B aortic dissection patients. Methods: From January 2016 to May 2020, 215 consecutive patients with acute or subacute non-A non-B aortic dissection were enrolled. The primary endpoints were all cause death. Secondary endpoints included follow up adverse aortic event (AE), a composite of the outcomes of dissection related death, rupture, retrograde type A aortic dissection, stent graft induced new entry tear, secondary endoleak, and follow up re-intervention. Kaplan–Meier curves were used to evaluate associations between different treatments and outcomes. Results: Among the 215 dissection patients, 127 (59.1%) received EBT, 42 (19.5%) received TAR + FET, and the remaining 46 (21.4%) received BMT. Thirty day mortality was higher in patients receiving TAR + FET (7.1%) than in those treated with EBT (1.6%) or BMT (2.2%) ( p = .12). However, after a median follow up of 39.1 (27.0 – 50.7) months, no additional death was recorded in the TAR + FET group, while nine (7.3%) patients died in the EBT group and 14 (31.8%) died in the BMT group ( p < .001). Specifically, EBT and TAR + FET showed no significant difference in midterm mortality rate, follow up AE, and re-intervention for complicated or uncomplicated dissection patients involving zone 2. For patients with uncomplicated non-A non-B aortic dissection involving zone 2, EBT could profoundly decrease the mortality rate, follow up AE and re-intervention when compared with BMT ( p < .010 for all), although this difference was not statistically significant between TAR + FET and BMT. No statistical comparison was performed in patients with zone 1 involvement because of the limited number of patients. Conclusion: It was demonstrated that EBT or TAR + FET might be a viable strategy for non-A non-B aortic dissection patients. … (more)
- Is Part Of:
- European journal of vascular and endovascular surgery. Volume 64:Number 5(2022)
- Journal:
- European journal of vascular and endovascular surgery
- Issue:
- Volume 64:Number 5(2022)
- Issue Display:
- Volume 64, Issue 5 (2022)
- Year:
- 2022
- Volume:
- 64
- Issue:
- 5
- Issue Sort Value:
- 2022-0064-0005-0000
- Page Start:
- 497
- Page End:
- 506
- Publication Date:
- 2022-11
- Subjects:
- Best medical treatment -- Endovascular based treatment -- Non-A non-B aortic dissection -- Outcomes -- Total arch replacement with frozen elephant trunk treatment
Blood-vessels -- Endoscopic surgery -- Periodicals
Blood-vessels -- Surgery -- Periodicals
Vascular Surgical Procedures -- Periodicals
Vascular Surgical Procedures -- methods -- Periodicals
Vaisseaux sanguins -- Chirurgie -- Périodiques
Vaisseaux sanguins -- Chirurgie endoscopique -- Périodiques
Blood-vessels -- Endoscopic surgery
Blood-vessels -- Surgery
Endoscopy
Electronic journals
Periodicals
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http://www.harcourt-international.com/journals/ejvs/ ↗
http://www.harcourt-international.com/journals/ejvx/ ↗
http://www.clinicalkey.com/dura/browse/journalIssue/10785884 ↗
http://www.clinicalkey.com.au/dura/browse/journalIssue/10785884 ↗
http://www.elsevier.com/journals ↗ - DOI:
- 10.1016/j.ejvs.2022.05.037 ↗
- Languages:
- English
- ISSNs:
- 1078-5884
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- Legaldeposit
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