Author + information
- Received October 26, 2012
- Accepted November 8, 2012
- Published online February 1, 2013.
- ↵⁎Reprint requests and correspondence:
Dr. Gao-Jun Teng, Department of Radiology, Zhongda Hospital, Medical School, Southeast University, Nanjing 210009, China
Objectives This study sought to evaluate the early and long-term effect of thoracic endovascular aortic repair (TEVAR) on type-B acute aortic dissection (AAD).
Background Uncomplicated type-B AAD is generally treated with medical management; complicated dissections require surgery or TEVAR. Studies have demonstrated that long-term outcomes with medical management are suboptimal. Therefore, we sought to determine the long-term effect of TEVAR compared with medical management alone on type-B AAD.
Methods From January 2004 to May 2008, 193 consecutive patients in 2 hospitals were treated and retrospectively placed into 1 of 2 groups: 1) the TEVAR group—type-B AAD treated with TEVAR and antihypertensive medications (n = 152); and the 2) medicine group—uncomplicated type-B AAD treated medically alone (n = 41). All TEVAR procedures were performed in the acute phase.
Results There were no significant differences in demographics, comorbidity profiles, or early events between groups. The cumulative freedom from all late adverse events at 1, 3, and 5 years was 97%, 89%, and 67% in the TEVAR group and 97%, 63%, and 34% in the medicine group. Log-rank tests showed that medically treated patients had more late adverse events than TEVAR-treated patients did (p = 0.003). The 5-year cumulative survival rate from all-cause death was not significantly different between the 2 groups.
Conclusions Patients with type-B AAD treated with TEVAR experienced fewer late adverse events than those treated with medical management, but there was no significant difference among the groups in 5-year mortality rates. Further studies of longer-term survival rates are needed to determine whether TEVAR could be an effective treatment for type-B AAD.
This study was supported by the National Natural Science Foundation of China (NSFC #30910103905). The authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- Received October 26, 2012.
- Accepted November 8, 2012.
- American College of Cardiology Foundation