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[Risk Factors for Adverse Aortic Remodeling in Post-TEVAR Patients with Acute Stanford B Aortic Dissection].
Yang, Peng; Huang, Yao; Hu, Jia; Xiao, Zheng-Hua; Jia, Bang-Sheng; Peng, Li-Qing; Zhang, Hong-Wei; Shen, Jia-Yu; Yang, Jian; Zhang, Er-Yong.
Affiliation
  • Yang P; Department of Cardiovascular Surgery, West China Hospital, Sichuan University, Chengdu 610041, China.
  • Huang Y; Department of Cardiovascular Surgery, West China Hospital, Sichuan University, Chengdu 610041, China.
  • Hu J; Department of Cardiovascular Surgery, West China Hospital, Sichuan University, Chengdu 610041, China.
  • Xiao ZH; Department of Cardiovascular Surgery, West China Hospital, Sichuan University, Chengdu 610041, China.
  • Jia BS; Department of Radiology, West China Hospital, Sichuan University, Chengdu 610041, China.
  • Peng LQ; Department of Radiology, West China Hospital, Sichuan University, Chengdu 610041, China.
  • Zhang HW; Department of Cardiovascular Surgery, West China Hospital, Sichuan University, Chengdu 610041, China.
  • Shen JY; Department of Cardiovascular Surgery, West China Hospital, Sichuan University, Chengdu 610041, China.
  • Yang J; Department of Cardiovascular Surgery, West China Hospital, Sichuan University, Chengdu 610041, China.
  • Zhang EY; Department of Cardiovascular Surgery, West China Hospital, Sichuan University, Chengdu 610041, China.
Sichuan Da Xue Xue Bao Yi Xue Ban ; 50(3): 357-361, 2019 May.
Article in Zh | MEDLINE | ID: mdl-31631603
OBJECTIVES: To assess morphological changes of distal aorta and the risk factors for adverse aortic remodeling inpost-TEVAR(thoracic endovascular aortic repair) patients with acute Stanford B aortic dissection. METHODS: We retrospectively investigated the patients who underwent TEVAR for a type B dissection between October 2005 and December 2015. CT angiogram (CTA) was obtained for each patients preoperatively, postoperatively and during the post-operational follow-up. Based on Criadol partition principle, we divided the aorta into descending thoracic aorta area, suprarenal abdominal aorta area, infrarenal abdominal aorta area and iliac artery area, and evaluated the distribution of aortic tears and the form of true and false lumen in different aortic partition. Univariate and multivariate logistic regression analyses were used to analyze the risk factors affecting distal aortic remodeling. RESULTS: Of 216 patients (mean follow-up (3.9±2.1) years) who were regularly followed up in our center, 47 patients (21.8%) occurred adverse remodeling in distal aorta. Univariate logistic regression indicated that abnormal aortic wall structure (Marfan's syndrome) and patent false lumen (existence of distal tears, decreased complete false lumen thrombosis) were associated with distal aortic adverse remodeling. Multivariate logistic regression showed that more tears in descending thoracic aorta area ( OR=1.36, 95% CI=1.12-1.58, P=0.005) and less tears in infrarenal abdominal aorta area ( OR=0.49, 95% CI=0.22-0.71, P<0.001) were independent risk factors affecting remodeling in distal aorta after TEVAR. CONCLUSIONS: Aortic wall structure abnormalities, a patent false lumen, more tears in descending thoracic aorta area, less tears in infrarenal abdominal aorta area are independent risk factors for adverse aortic remodeling in post-TEVAR patients with acute Stanford B aortic dissection.
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Collection: 01-internacional Database: MEDLINE Main subject: Aortic Aneurysm, Thoracic / Endovascular Procedures / Vascular Remodeling / Aortic Dissection Type of study: Etiology_studies / Observational_studies / Risk_factors_studies Limits: Humans Language: Zh Journal: Sichuan Da Xue Xue Bao Yi Xue Ban Year: 2019 Document type: Article Affiliation country: China Country of publication: China
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Collection: 01-internacional Database: MEDLINE Main subject: Aortic Aneurysm, Thoracic / Endovascular Procedures / Vascular Remodeling / Aortic Dissection Type of study: Etiology_studies / Observational_studies / Risk_factors_studies Limits: Humans Language: Zh Journal: Sichuan Da Xue Xue Bao Yi Xue Ban Year: 2019 Document type: Article Affiliation country: China Country of publication: China