ISSN : 1301-5680
e-ISSN : 2149-8156
Turkish Journal of Thoracic and Cardiovascular Surgery     
Does endovascular repair affect aortic remodeling in acute complicated type B aortic dissection?
Serkan Ertugay1, Halil Bozkaya2, Celal Çınar2, Mustafa Parıldar2, Hakan Posacıoğlu1
1Departments of Cardiovascular Surgery, Medical Faculty of Ege University, İzmir, Turkey
2Departments of Radiology, Medical Faculty of Ege University, İzmir, Turkey
DOI : 10.5606/tgkdc.dergisi.2015.11717
Background: This study aims to analyze the volume changes of true and false lumens at a late stage in patients undergoing thoracic endovascular aortic repair (TEVAR) due to acute complicated type B aortic dissection.

Methods: Between March 2006 and November 2012, 18 consecutive patients (14 males, 4 females; mean age was 61.9±11 years; range 39 to 77 years) who underwent TEVAR for acute complicated type B aortic dissection in our clinic were included in this study. Computed tomography scans obtained at the final visit were used for the volume analysis of true and false lumens. The median follow-up was 35.3 (range, 12 to 84) months. Indications for intervention were rupture or malperfusion in 17 patients (both in some patients) and persistent chest pain in one patient. The stent-graft part of the descending thoracic aorta (DTA) was defined as Segment 1, DTA without stent-graft (supraceliac) as Segment 2, and the abdominal aorta as Segment 3.

Results: In segment 1, the mean volume of true lumen increased from 74.4±49 mL to 110±50 mL (p=0.0145), while the mean volume of false lumen decreased from 124.2±81 mL to 59.5±59 mL (p<0.00001). In segment 2, the mean volume of true lumen increased from 23.1±28 mL to 40.5±33 mL (p=0.0015), while the mean volume of false lumen decreased from 32.8±29 mL to 29±1 mL (p=0.624). In segment 3, the mean volume of true lumen increased from 46.5±63 mL to 57.3±74 mL (p=0.0388), the mean volume of false lumen decreased from 41.8±30 mL to 37.6±32 mL (p=0.5195). True and false lumens volume changes were statistically significant except volume decrease in segment 3.

Conclusion: Endovascular repair of type B aortic dissection may positively affect aortic remodeling in chronic settings and may prevent possible aorta-related complications during longterm follow-up.

Keywords : Aortic remodeling; complicated type B aortic dissection; thoracic endovascular aortic repair
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