Clinical follow-up of thoracic endovascular aortic repair in treatment of acute Stanford B dissection

AIM:To evaluate the mid-term results of thoracic endovascular aortic repair (TEVAR) in treatment of acute Stanford B dissection. METHODS: From December 2001 to June 2009, 288 patients (237 males, 51 females; average age 51.2 years) with acute Stanford B dissection were enrolled in our institution and received TEVAR. Stent grafts were placed to exclude primary tear of dissection under general or local anesthesia. All patients were followed-up by multisliced CT for an average of 38 months (6-102 months). Thrombus formation of false lumen, presence of endoleak, hemodynamic changes, position and shape of the stent graft, and blood supply of visceral vessels were all evaluated. RESULTS: All stent grafts were placed in the desired position and no migration, dissection rupture, conversion or paraplegia were observed during TEVAR. There were six perioperative deaths. Two patients died due to ischemia-reperfusion syndrome, one died due to retrograde Stanford A dissection, one due to rupture of dissection, one due to myocardial infarction and one without obvious reasons. Perioperative complications (25.3%) included instant endoleak, fever, renal insufficiency, infection, pneumonia, central nervous system disorder, cardiac insufficiency, pseudo-aneurysm and amputation. There were seven deaths during the follow-up period and four patients received reintervention. Kaplan-Meier curve showed an estimated 5-year survival rate of 96%. CONCLUSION: TEVAR is less invasive, safe and feasible as an effective method in treatment of acute Stanford B dissection and produces good mid-term results.