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Comparison of long-term clinical outcome between patients with chronic versus acute type B aortic dissection treated by implantation of a stent graft: a single-center report

Authors Chen S, Zhu J, Li X, Ye F, Zhang J, Liu Z, Tian N, Lin S, Lv V

Received 10 October 2012

Accepted for publication 28 November 2012

Published 22 April 2013 Volume 2013:7 Pages 319—327


Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 4

Shao-Liang Chen, Jian-Cheng Zhu, Xiao-Bo Li, Fei Ye, Jun-Jie Zhang, Zhi-Zhong Liu, Nai-Liang Tian, Song Lin, Cheng-Yu Lv

Nanjing First Hospital, Nanjing Medical University, Nanjing, People's Republic of China

Background: Stent grafting for treatment of type B aortic dissection has been extensively used. However, the difference in the long-term clinical outcome between patients with chronic versus acute type B aortic dissection remains unknown. This study aimed to analyze the difference in long-term clinical outcome after endovascular repair for patients with chronic (<2 weeks) versus acute (≥2 weeks) type B aortic dissection.
Methods: Between May 2000 and June 2011, a total of 174 patients with type B aortic dissection (56 chronic, 118 acute) treated by endovascular repair were studied prospectively. Follow-up three-dimensional computed tomography scanning and aortoangiography were scheduled at 3–6 months after the index procedure. Propensity score matching was used to compare the difference in the endpoint between the two groups.
Results: The procedure-related event rate was 18.6% in the acute group and 5.4% in the chronic group (P = 0.021), but this difference became nonsignificant after propensity score matching. At the end of follow-up (mean 2.49 years), overall and aorta-related mortality was 11.0% and 7.6%, respectively, in the acute group, and was not significantly different from that in the chronic group (3.6% and 3.6%, P = 0.148 and P = 0.506, respectively). Both false and true lumina showed significant remodeling over time, with >93% complete false-lumen thrombosis. Untreated tear and type I endoleak were predictors of clinical events during follow-up.
Conclusion: Comparable long-term clinical results were achieved in patients with chronic or acute type B aortic dissection after implantation of a stent graft.

Keywords: aortic dissection, endovascular repair, procedure-related events, propensity score matching

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