The beneficial enlightenment of thoracic endovascular aortic repair for traumatic type B aortic dissection with long-term follow-up of single center / 中华胸心血管外科杂志

ABSTRACT

Objective To evaluate the long-term clinical effect of Thoracic endovascular aortic repair (TEVAR) for traumatic Type B aortic dissection,and to provide a reference for the next stage treatment.Methods Twenty-one patients with traumatic Stanford type B aortic dissection treated in our center from December 1999 to June 2012 were retrospectively analyzed for the treatment effectiveness and follow-up results.The average age of 21 Traumatic Type B aortic dissection patients was 42.7 years (range19 to 67 years).Men accounted for 85.7％ (18/21).80.9％ (17/21) of the dissection were caused by car accident,4 were due to falling accident from high places.There were 7 cases of hypertension,4 cases of diabetes,4 cases of hyperlipidemia,2 cases of chronic ischemic heart disease,14 cases of pneumothorax,8 cases of rib fracture,3 cases of craniocerebral trauma / neuropsychiatric symptoms,and 1 patient with shock.The median time from onset to treatment was 5 days (range1-73 days).There were 16 cases (≤14 days) in the acute phase,2 cases (15-60 days) in the subacute phase,and 3 cases (＞ 60 days) in the chronic phase.There was no patient in super acute phase in the study group (0-24 hour).Results The perioperative mortality was 9.52％ (2/21) for the patients traumatic type B aortic dissection,4.76％ (1/21)for those with postoperative endoleaks;2-year and 5-year survival rates were 90.48％ and 85.71％.Conclusion Intracavitary treatment of traumatic Stanford B type aortic dissection is effective and has good long-term clinical benefit,which provides a guidance for future clinical treatment of traumatic type B aortic dissection.