False lumen patency status and outcomes after endovascular repair of uncomplicated chronic type B dissection

Catheter Cardiovasc Interv. 2022 Oct;100(4):696-704. doi: 10.1002/ccd.30360. Epub 2022 Sep 13.


Background: Thoracic endovascular aortic repair (TEVAR) remains a controversial treatment for uncomplicated chronic type B aortic dissection (cTBAD). This study was performed to investigate the postoperative outcomes of TEVAR, such as survival and reintervention, and the risk factors for prognoses.

Methods: In total, 41 patients with uncomplicated cTBAD who underwent TEVAR from 2014 to 2021 were reviewed. The patients were divided into two groups: those with false lumen complete thrombosis (FLCT) and false lumen partial thrombosis (FLPT) based on computed tomography angiography (CTA) images. Kaplan-Meier analysis was performed to estimate survival and freedom from reintervention. Binary logistic analysis was performed to estimate risk factors for partial thrombosis.

Results: During a mean follow-up of 31 (1-78) months, five deaths and six reinterventions had occurred at 5 years. By 1 week, thoracic FLCT had occurred in 23 (56.1%) patients and thoracic FLPT had occurred in 18 (43.9%). The rate of freedom from reintervention was significantly lower in the FLCT than in the FLPT group (p = 0.04). The 5-year survival rate of the two groups was not statistically significant (p = 0.14). Risk factors for thoracic FLPT were the distance between the re-entry site and the graft (p = 0.02) and the proximal oversizing ratio (p = 0.04).

Conclusions: TEVAR is an effective and safe treatment for uncomplicated cTBAD and has a low mortality rate. Thoracic FLCT is associated with less reintervention, but overall survival is not impacted by this difference. Patients treated with TEVAR without certain risk factors can have a good prognosis.

Keywords: prognosis; risk factors; thoracic endovascular aortic repair; thrombosis.

MeSH terms

  • Aortic Aneurysm, Thoracic* / diagnostic imaging
  • Aortic Aneurysm, Thoracic* / etiology
  • Aortic Aneurysm, Thoracic* / surgery
  • Aortic Dissection* / diagnostic imaging
  • Aortic Dissection* / etiology
  • Aortic Dissection* / surgery
  • Blood Vessel Prosthesis Implantation* / adverse effects
  • Endovascular Procedures* / adverse effects
  • Humans
  • Retrospective Studies
  • Risk Factors
  • Stents
  • Thrombosis* / etiology
  • Time Factors
  • Treatment Outcome