Endovascular treatment for Stanford type B aortic dissection in Marfan syndrome patients: a series of 23 cases
10.3760/cma.j.cn112139-20230905-00092
- VernacularTitle:腔内修复治疗马方综合征患者Stanford B型主动脉夹层的效果分析
- Author:
Xiaolang JIANG
1
;
Hao LIU
;
Lingwei ZOU
;
Bin CHEN
;
Junhao JIANG
;
Daqiao GUO
;
Xin XU
;
Zhihui DONG
;
Weiguo FU
Author Information
1. 复旦大学附属中山医院血管外科 国家放射与治疗临床医学研究中心，上海 200032
- Keywords:
Marfan syndrome;
Aortic diseases;
Type B aortic dissection;
Endovascular repair
- From:
Chinese Journal of Surgery
2024;62(5):438-442
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the clinical outcomes of thoracic endovascular aortic repair (TEVAR) in the treatment of Stanford type B aortic dissection (TBAD) in Marfan syndrome patients who had no history of aortic arch replacement.Methods:This is a retrospective case-series study. From January 2009 to December 2019,the clinical data of Marfan syndrome patients who underwent TEVAR for TBAD at the Department of Vascular Surgery were collected. A total of 23 patients were enrolled,including 15 males and 8 females. The age was (38.0±11.0) years (range:24 to 56 years). Among them,12 patients had history of ascending aortic surgery. Details of TEVAR,perioperative complications and reintervention were recorded and survival rate was analyzed by Kaplan-Meier curve.Results:Technical success was 91.3% (21/23). Two patients with technical failure were as follows:one patient had type Ⅰa endoleak at the completion angiography,which healed spontaneously during the follow-up,and the other patient suffered aortic intimal intussusception after the deployment of the first stent-graft, and the second stent-graft was deployed. However, type Ⅲ endoleak was detected,which disappeared during the follow-up. One patient died during hospitalization. The median follow-up time ( M(IQR)) was 60 (48) months (range:12 to 132 months). Reintervention was performed on 7 patients,including 3 distal stent-graft-induced new entry,2 distal aortic dilation,1 Ⅰa endoleak and 1 retrograde type A aortic dissection,respectively. Five-year cumulative survival rate was 86.7% (95% CI:86.6% to 86.8%) and the 5-year freedom from reintervention rate was 81.8% (95% CI:61.8% to 92.8%). Conclusions:TEVAR is feasible in the treatment of TBAD in Marfan syndrome patients who has no history of aortic arch replacement. It has high technical success rate and low perioperative complication.
