Reintervention for distal residual dissection after proximal repair of acute aortic dissection: experience of aortic endovascular remodeling device
10.3760/cma.j.cn112434-20240426-00113
- VernacularTitle:急性主动脉夹层近端修复术后远端残余夹层的再干预：主动脉腔内全程重塑装置(AERD)的应用
- Author:
Wenfan LI
1
;
Chen LU
;
Peng YANG
;
Yu LIU
;
Haiyue WANG
;
Wei MENG
;
Zhenghua XIAO
;
Jia HU
Author Information
1. 四川大学华西医院心脏大血管外科，成都 610041
- Keywords:
Acute aortic dissection;
Residual dissection;
Aortic endovascular remodeling device;
Distal aortic remodeling
- From:
Chinese Journal of Thoracic and Cardiovascular Surgery
2024;40(6):339-344
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyzed the 3-year follow-up results in a single center to evaluate the mid-term clinical efficacy of aortic endovascular remodeling device(AERD).Methods:From January 2019 to June 2019, 18 patients with residual aortic dissection after proximal repair of acute aortic dissection were treated with AERD in our heart center of West China Hospital of Sichuan University. They were followed up for 3 years after surgery and underwent vascular enhanced CT review. The primary outcome of our study included all-cause mortality and stent-related mortality. Secondary outcome included branch patency rate, reoperation rate and the incidence of serious adverse events. Morphological measures assessed the effectiveness of AERD in treating residual distal dissection.Results:17 patients completed the 3-year follow-up, and 1 was lost to follow-up. There was no stent-related death, branch artery occlusion, or new serious adverse events. 12 patients completed vascular enhanced CT review, the true lumen was significantly expanded and the false lumen was reduced considerably at 3-year follow-up, true lumen volume, (52.39±22.32)cm 3 vs. (74.34±14.64) cm 3( P<0.01), false lumen volume(50.42±25.44) cm 3 vs. (32.32±31.75)cm 3( P<0.01). Increased true lumen diameter and area ( P<0.001) and decreased false lumen diameter( P<0.001) were significantly different from those before operation, especially in the level below the renal artery and 5 cm below the renal artery. Conclusion:The mid-term effect of AERD in treating distal residual dissection is satisfactory, and it promoted positive distal aorta remodeling with safety and effectiveness.
