Early and long-term outcome after thoracic endovascular aortic repair (TEVAR) for acute complicated type B aortic dissection.

Abstract

The study aimed to investigate early and long-term outcome of thoracic endovascular aortic repair (TEVAR) for acute complicated type B dissection. This was a retrospective, single-centre, consecutive case series. During the period 1999-2009, TEVAR was carried out in 50 patients with non-traumatic acute complicated type B dissection, and in another 10 patients with acute complications, including rupture, end-organ ischaemia and acute dilatation during the primary hospitalisation, but >14 days after onset of symptoms. Thus, in total, 60 patients were included; 22 with a DeBakey type IIIa dissection and 38 with a type IIIb; median age was 67 years. Early (30-day) and long-term (5-year) survival, re-intervention rate and complications were recorded until 1 July 2010. Within 30 days, two (3%) deaths, one (2%) paraplegia and three (5%) strokes were observed. Five-year survival was 87% and freedom from re-intervention at 5 years was 65%. In patients with acute complicated type B aortic dissection, TEVAR can be performed with excellent early and long-term survival, whereas morbidity and long-term durability must be further elucidated.