초록접수 현황
| 16F-146 | 구연 발표 |
The Effect of False Lumen Procedures during Thoracic Endovascular Aortic Repair in Patients with Chronic DeBakey IIIb Aneurysm
Tae-Hoon Kim¹, Suk-Won Song¹, Kwang-Hun Lee²,Won-Ki Woo¹, Min-Young Baek¹, Kyung-Jong Yoo³, Bum-Koo Cho³
¹Department of Thoracic and Cardiovascular Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea, ²Department of Radiology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea, ³Department of Thoracic and Cardiovascular Surgery, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea
Background : Although thoracic endovascular aortic repair (TEVAR) is commonly used for Chronic DeBakey IIIb (CDIIIb) aneurysms, the aortic remodeling after TEVAR in CDIIIb aneurysms is not yet satisfactory. Persistent retrograde flow to the false lumen (FL) through reentry tears is a common cause of failure. We sought to clarify the safety and the effect of false lumen procedure (FLP) for the aortic remodeling in CDIIIb patients.
Methods : From 2012 to 2016, 73 patients underwent TEVAR in CDIIIb aneurysm. TEVAR with FLP was performed in 41 patients (group A, 56%) and 32 patients (group B, 44%) underwent simple TEVAR. Outcomes included whole thoracic aorta FL thrombosis and diameter change in the true lumen (TL) and FL. Diameters were measured at 3 levels (left subclavian artery, pulmonary artery bifurcation, and celiac axis).
Results : No in-hospital mortality and procedure-related complication was observed. There was one paraplegia and one stroke after procedure. Whole thoracic aorta FL thrombosis rate was significantly higher in groud A (83% vs. 56%, p = 0.019). Significant aortic remodeling (TL expansion and FL regression after procedure) was observed in both groups (Figure 1-(A), F1-(B)). In multivariate logistic regression, FLP was an independent favorable factor and intima tears below the celiac axis was a poor prognostic factor for FL thrombosis (p = 0.005, and p = 0.007, respectively).
Conclusion : FLP was safe, promoted FL thrombosis, and had favorable aortic remodeling in patients with CDIIIb aneurysms. Supra-celiac TEVAR with FLP seems to be the optimal endovascular treatment in CDIIIb patients.
Methods : From 2012 to 2016, 73 patients underwent TEVAR in CDIIIb aneurysm. TEVAR with FLP was performed in 41 patients (group A, 56%) and 32 patients (group B, 44%) underwent simple TEVAR. Outcomes included whole thoracic aorta FL thrombosis and diameter change in the true lumen (TL) and FL. Diameters were measured at 3 levels (left subclavian artery, pulmonary artery bifurcation, and celiac axis).
Results : No in-hospital mortality and procedure-related complication was observed. There was one paraplegia and one stroke after procedure. Whole thoracic aorta FL thrombosis rate was significantly higher in groud A (83% vs. 56%, p = 0.019). Significant aortic remodeling (TL expansion and FL regression after procedure) was observed in both groups (Figure 1-(A), F1-(B)). In multivariate logistic regression, FLP was an independent favorable factor and intima tears below the celiac axis was a poor prognostic factor for FL thrombosis (p = 0.005, and p = 0.007, respectively).
Conclusion : FLP was safe, promoted FL thrombosis, and had favorable aortic remodeling in patients with CDIIIb aneurysms. Supra-celiac TEVAR with FLP seems to be the optimal endovascular treatment in CDIIIb patients.
책임저자: Suk-Won Song
Department of Thoracic and Cardiovascular Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
발표자: Tae-Hoon Kim, E-mail : airtech2@naver.com