Incidence and risk factors for retrograde type A dissection and stent graft-induced new entry after thoracic endovascular aortic repair

Incidence and risk factors for retrograde type A dissection and stent graft-induced new entry after thoracic endovascular aortic repair

Stent graft (SG)-induced new entry (SINE) and retrograde type A dissection (RTAD) are serious device-related complications occurring after thoracic endovascular aortic repair (TEVAR) for Stanford type B aortic dissection (TBAD) and may lead to endograft-related complications including retrograde dis...

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Veröffentlicht in:Journal of vascular surgery 2018-04, Vol.67 (4), p.1026-1033.e2
Hauptverfasser: Ma, Tao, Dong, Zhi Hui, Fu, Wei Guo, Guo, Da Qiao, Xu, Xin, Chen, Bin, Jiang, Jun Hao, Yang, Jue, Shi, Zhen Yu, Zhu, Ting, Shi, Yun, Jiang, Bao Hong, Xu, Xiao Yun
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container_end_page 1033.e2
container_issue 4
container_start_page 1026
container_title Journal of vascular surgery
container_volume 67
creator Ma, Tao
Dong, Zhi Hui
Fu, Wei Guo
Guo, Da Qiao
Xu, Xin
Chen, Bin
Jiang, Jun Hao
Yang, Jue
Shi, Zhen Yu
Zhu, Ting
Shi, Yun
Jiang, Bao Hong
Xu, Xiao Yun
description Stent graft (SG)-induced new entry (SINE) and retrograde type A dissection (RTAD) are serious device-related complications occurring after thoracic endovascular aortic repair (TEVAR) for Stanford type B aortic dissection (TBAD) and may lead to endograft-related complications including retrograde dissection and death. The purpose of this study was to investigate the incidence and risk factors for the development of RTAD and SINE after TEVAR for TBAD and to identify the complications associated with this. From April 2005 to October 2013, there were 997 patients who underwent TEVAR for TBAD; 852 were followed up (0-6 years; mean, 2.6 years), and 59 SINEs developed in 53 patients. The oversizing ratio and incidence of RTAD and SINE were compared between proximal bare stent (PBS) and non-PBS groups and RTAD and SINE and non-RTAD and non-SINE groups. The baseline characteristics and SG configurational factors potentially affecting both RTAD and distal SINE were analyzed. There was no significant difference between PBS and non-PBS groups in the incidence of RTAD. A greater oversizing ratio was related to a higher distal SINE rate. SINE was seen more frequently in smokers and in patients with hypertension, Marfan syndrome, and TEVAR in the chronic phase and less frequently in complicated dissection cases. Device-related factors for SINE were SG with a connecting bar and SG length 
doi_str_mv 10.1016/j.jvs.2017.08.070
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The purpose of this study was to investigate the incidence and risk factors for the development of RTAD and SINE after TEVAR for TBAD and to identify the complications associated with this. From April 2005 to October 2013, there were 997 patients who underwent TEVAR for TBAD; 852 were followed up (0-6 years; mean, 2.6 years), and 59 SINEs developed in 53 patients. The oversizing ratio and incidence of RTAD and SINE were compared between proximal bare stent (PBS) and non-PBS groups and RTAD and SINE and non-RTAD and non-SINE groups. The baseline characteristics and SG configurational factors potentially affecting both RTAD and distal SINE were analyzed. There was no significant difference between PBS and non-PBS groups in the incidence of RTAD. A greater oversizing ratio was related to a higher distal SINE rate. SINE was seen more frequently in smokers and in patients with hypertension, Marfan syndrome, and TEVAR in the chronic phase and less frequently in complicated dissection cases. 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title Incidence and risk factors for retrograde type A dissection and stent graft-induced new entry after thoracic endovascular aortic repair
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