Cover Image

Thoracic Endovascular Aortic Repair (TEVAR) first in patients with lower limb ischemia in complicated type B aortic dissection: clinical outcome and morphology

Acute Type B aortic dissection (TBAD) can cause organ malperfusion, e.g., lower limb ischemia (LLI). Thoracic endovascular aortic repair (TEVAR) represents the standard treatment for complicated TBAD; however, with respect to LLI, data is scant. The aim of this study was to investigate clinical and...

Full description

Saved in:
Bibliographic Details
Main Authors: Meisenbacher, Katrin (Author) , Hagedorn, Matthias (Author) , Skrypnik, Denis (Author) , Kilian, Samuel (Author) , Böckler, Dittmar (Author) , Bischoff, Moritz (Author) , Peters, Andreas (Author)
Format: Article (Journal)
Language:English
Published: 17 July 2022
In: Journal of Clinical Medicine
Year: 2022, Volume: 11, Issue: 14, Pages: 1-14
ISSN:2077-0383
DOI:10.3390/jcm11144154
Online Access:Verlag, kostenfrei, Volltext: https://doi.org/10.3390/jcm11144154
Verlag, kostenfrei, Volltext: https://www.mdpi.com/2077-0383/11/14/4154
Get full text
Author Notes:Katrin Meisenbacher, Matthias Hagedorn, Denis Skrypnik, Samuel Kilian, Dittmar Böckler, Moritz S. Bischoff and Andreas S. Peters
Description
Summary:Acute Type B aortic dissection (TBAD) can cause organ malperfusion, e.g., lower limb ischemia (LLI). Thoracic endovascular aortic repair (TEVAR) represents the standard treatment for complicated TBAD; however, with respect to LLI, data is scant. The aim of this study was to investigate clinical and morphological outcomes in patients with complicated TBAD and LLI managed with a “TEVAR-first” policy. Between March 1997 and December 2021, 731 TEVAR-procedures were performed, including 106 TBAD-cases. Cases with TBAD + LLI were included in this retrospective analysis. Study endpoints were morphological/clinical success of TEVAR, regarding aortic and extremity-related outcome, including extremity-related adjunct procedures (erAP) during a median FU of 28.68 months. A total of 20/106 TBAD-cases (18.8%, 32-82 years, 7 women) presented with acute LLI (12/20 Rutherford class IIb/III). In 15/20 cases, true lumen-collapse (TLC) was present below the aortic bifurcation. In 16/20 cases, TEVAR alone resolved LLI. In the remaining four cases, erAP was necessary. A morphological analysis showed a relation between lower starting point and lesser extent of TLC and TEVAR success. No extremity-related reinterventions and only one major amputation was needed. The data strongly suggest that aTEVAR-first-strategy for treating TBAD with LLI is reasonable. Morphological parameters might be of importance to anticipate the failure of TEVAR alone.
Item Description:Gesehen am 17.08.2022
Physical Description:Online Resource
ISSN:2077-0383
DOI:10.3390/jcm11144154

Similar Items