Comparison of Outcomes and Complications Among Patients with Different Indications of Acute/Subacute Complicated Stanford Type B Aortic Dissection Treated by TEVAR: Data from the JaPanese REtrospective multicenter stuDy of ThoracIc Endovascular Aortic Repair for Complicated Type B Aortic Dissection (J-Predictive Study)

Shinichi Iwakoshi, Yoshihito Irie, Yoshiaki Katada, Shoji Sakaguchi, Norio Hongo, Katsuki Oji, Tetsuya Fukuda, Hitoshi Matsuda, Ryota Kawasaki, Takanori Taniguchi, Manabu Motoki, Makiyo Hagihara, Yoshihiko Kurimoto, Noriyasu Morikage, Hiroshi Nishimaki, Yukihisa Ogawa, Eijun Sueyoshi, Kyozo Inoue, Hideyuki Shimizu, Ichiro IdetaTakatoshi Higashigawa, Osamu Ikeda, Naokazu Miyamoto, Motoki Nakai, Takahiro Nakai, Takashi Inoue, Takeshi Inoue, Shigeo Ichihashi, Kimihiko Kichikawa

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)

Abstract

Purpose: To investigate the relationships between indications for thoracic endovascular aortic repair for acute/subacute complicated Stanford type B aortic dissection and clinical outcomes, and complications specific to thoracic endovascular aortic repair. Material and methods: The J-predictive study retrospectively collected data of patients treated with thoracic endovascular aortic repair for complicated Stanford type B aortic dissection at 20 institutions from January 2012 to March 2017. From the database, those treated for acute/subacute complicated Stanford type B aortic dissection were extracted (n = 118; 96 men; average age, 66.1 years; standard deviation, ± 13) and classified into groups 1, 2, and 3 according to thoracic endovascular aortic repair indications (rupture, superior mesenteric artery malperfusion, and renal or lower extremity malperfusion, respectively). Primary and secondary measures were mortality (overall and aortic-related) and complications related to thoracic endovascular aortic repair, respectively. For each outcome, the risks of being in groups 1 and 2 were statistically compared with that of being in group 3 as a control using Fisher’s exact test. Results: Mortality rate (odds ratio, 5.22; 95% confidence interval [CI], 1.33–20.53) and prevalence of paraparesis/paraplegia (odds ratio, 30.46; confidence interval, 1.71–541.77) were higher in group 1 than in group 3. Compared to group 3, group 2 showed no statistically significant differences in mortality or complications related to thoracic endovascular aortic repair. Conclusions: Rupture as an indication for thoracic endovascular aortic repair for type B aortic dissection was more likely to result in worse mortality and high prevalence of spinal cord ischemia. Level of Evidence: Level 4, Case series.

Original languageEnglish
Pages (from-to)290-297
Number of pages8
JournalCardiovascular and Interventional Radiology
Volume45
Issue number3
DOIs
Publication statusPublished - 2022 Mar

Keywords

  • Aortic dissection
  • Indicators
  • Rupture
  • Thoracic aortic aneurysm

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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