Aortic remodeling after endovascular repair with stainless steel-based stent graft in acute and chronic type B aortic dissection Chih-Pei Ou Yang, MD,

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Presentation transcript:

Aortic remodeling after endovascular repair with stainless steel-based stent graft in acute and chronic type B aortic dissection Chih-Pei Ou Yang, MD, Chiao-Po Hsu, MD, Wei-Yuan Chen, MD, I-Ming Chen, MD, Chi-Feng Weng, MD, Chun-Ku Chen, MD, Chun- Che Shih, MD, PhD Journal of Vascular Surgery Volume 55, Issue 6, Pages 1600-1610 (June 2012) DOI: 10.1016/j.jvs.2011.12.008 Copyright © 2012 Society for Vascular Surgery Terms and Conditions

Fig 1 Prestent and poststent graft procedural measurements on A, B, C, and D levels. Journal of Vascular Surgery 2012 55, 1600-1610DOI: (10.1016/j.jvs.2011.12.008) Copyright © 2012 Society for Vascular Surgery Terms and Conditions

Fig 2 Kaplan-Meier survival curve in patients after stainless steel-based stent graft repair for aortic acute dissection (AD) and chronic dissection (CD) groups. The P values were calculated by the log-rank test. Journal of Vascular Surgery 2012 55, 1600-1610DOI: (10.1016/j.jvs.2011.12.008) Copyright © 2012 Society for Vascular Surgery Terms and Conditions

Fig 3 Typical regression process after emergent thoracic endovascular aneurysm repair (TEVAR) for acute type B dissection with visceral malperfusion. A, Preoperative computed tomographic angiography (CTA) with patent false lumen. B, Postoperative 1 week with false lumen thrombosis of entire thoracic aorta. C, Postoperative 1 year with perigraft complete regression (false lumen obliteration) but false lumen of abdominal aortic portion still patent. D, Postoperative 2 years with near-total false lumen regression and only insignificant residual dissection noted at visceral level. Journal of Vascular Surgery 2012 55, 1600-1610DOI: (10.1016/j.jvs.2011.12.008) Copyright © 2012 Society for Vascular Surgery Terms and Conditions

Fig 4 The true lumen dilatation and false lumen regression trend at different measure levels along with time after thoracic endovascular aneurysm repair (TEVAR; comparison between acute and chronic dissection). *P < .05 (analysis of variance). Journal of Vascular Surgery 2012 55, 1600-1610DOI: (10.1016/j.jvs.2011.12.008) Copyright © 2012 Society for Vascular Surgery Terms and Conditions

Fig 5 Representative erosion process of the dissection membrane at the distal end of stent graft after emergent thoracic endovascular aneurysm repair (TEVAR) for rupture aortic aneurysm of chronic type B dissection. A, Postoperative 1 week with intact intimomedial membrane. B, Sagittal view postoperative 1-week axial view. C, Postoperative 1 year with distal erosion of intimomedial membrane. D, Sagittal view postoperative 1-year axial view. White arrows indicate the erosion of the intimomedial membrane at the distal end of the stent graft. Journal of Vascular Surgery 2012 55, 1600-1610DOI: (10.1016/j.jvs.2011.12.008) Copyright © 2012 Society for Vascular Surgery Terms and Conditions

Fig 6 The true lumen dilatation and false lumen regression trend at different measure levels along with time after thoracic endovascular aneurysm repair (TEVAR). The “enlarge” and “decrease” of the true and false lumen were defined by more than 5-mm interval diameter change compared with preprocedure computed tomography (CT) scan. The “stasis” was defined by a change of <5 mm. A, True lumen regression of acute dissection at pulmonary artery (PA) level. B, False lumen regression of acute dissection at PA level. C, True lumen regression of acute dissection at celiac level. D, False lumen regression of acute dissection at celiac level. E, True lumen regression of chronic dissection at PA level. F, False lumen regression of chronic dissection at PA level. G, True lumen regression of chronic dissection at celiac level. H, False lumen regression of chronic dissection at celiac level. Journal of Vascular Surgery 2012 55, 1600-1610DOI: (10.1016/j.jvs.2011.12.008) Copyright © 2012 Society for Vascular Surgery Terms and Conditions