Endovascular Repair of Type B Aortic Dissection

  • Christoph A. Nienaber
    From the University of Rostock, Heart Center and Institute for Biostatistics, Rostock, Germany (C.A.N., S.K., T.C.R., G.K., A.G., T.K., H.I.); CCB Heart Center Frankfurt, Frankfurt, Germany (H.E.); University Heart Center Leipzig, Leipzig, Germany (D.S.); German Heart Institute Berlin, Berlin, Germany (B.Z.); the Centre Hospitalière Universitaire, Hôpital de Rangueil, Toulouse, France (H.R.); the Universitá St. Orsola Malpighi, Bologna, Italy (R.F.); the Department of Cardiovascular Surgery,...
  • Stephan Kische
    From the University of Rostock, Heart Center and Institute for Biostatistics, Rostock, Germany (C.A.N., S.K., T.C.R., G.K., A.G., T.K., H.I.); CCB Heart Center Frankfurt, Frankfurt, Germany (H.E.); University Heart Center Leipzig, Leipzig, Germany (D.S.); German Heart Institute Berlin, Berlin, Germany (B.Z.); the Centre Hospitalière Universitaire, Hôpital de Rangueil, Toulouse, France (H.R.); the Universitá St. Orsola Malpighi, Bologna, Italy (R.F.); the Department of Cardiovascular Surgery,...
  • Hervé Rousseau
    From the University of Rostock, Heart Center and Institute for Biostatistics, Rostock, Germany (C.A.N., S.K., T.C.R., G.K., A.G., T.K., H.I.); CCB Heart Center Frankfurt, Frankfurt, Germany (H.E.); University Heart Center Leipzig, Leipzig, Germany (D.S.); German Heart Institute Berlin, Berlin, Germany (B.Z.); the Centre Hospitalière Universitaire, Hôpital de Rangueil, Toulouse, France (H.R.); the Universitá St. Orsola Malpighi, Bologna, Italy (R.F.); the Department of Cardiovascular Surgery,...
  • Holger Eggebrecht
    From the University of Rostock, Heart Center and Institute for Biostatistics, Rostock, Germany (C.A.N., S.K., T.C.R., G.K., A.G., T.K., H.I.); CCB Heart Center Frankfurt, Frankfurt, Germany (H.E.); University Heart Center Leipzig, Leipzig, Germany (D.S.); German Heart Institute Berlin, Berlin, Germany (B.Z.); the Centre Hospitalière Universitaire, Hôpital de Rangueil, Toulouse, France (H.R.); the Universitá St. Orsola Malpighi, Bologna, Italy (R.F.); the Department of Cardiovascular Surgery,...
  • Tim C. Rehders
    From the University of Rostock, Heart Center and Institute for Biostatistics, Rostock, Germany (C.A.N., S.K., T.C.R., G.K., A.G., T.K., H.I.); CCB Heart Center Frankfurt, Frankfurt, Germany (H.E.); University Heart Center Leipzig, Leipzig, Germany (D.S.); German Heart Institute Berlin, Berlin, Germany (B.Z.); the Centre Hospitalière Universitaire, Hôpital de Rangueil, Toulouse, France (H.R.); the Universitá St. Orsola Malpighi, Bologna, Italy (R.F.); the Department of Cardiovascular Surgery,...
  • Guenther Kundt
    From the University of Rostock, Heart Center and Institute for Biostatistics, Rostock, Germany (C.A.N., S.K., T.C.R., G.K., A.G., T.K., H.I.); CCB Heart Center Frankfurt, Frankfurt, Germany (H.E.); University Heart Center Leipzig, Leipzig, Germany (D.S.); German Heart Institute Berlin, Berlin, Germany (B.Z.); the Centre Hospitalière Universitaire, Hôpital de Rangueil, Toulouse, France (H.R.); the Universitá St. Orsola Malpighi, Bologna, Italy (R.F.); the Department of Cardiovascular Surgery,...
  • Aenne Glass
    From the University of Rostock, Heart Center and Institute for Biostatistics, Rostock, Germany (C.A.N., S.K., T.C.R., G.K., A.G., T.K., H.I.); CCB Heart Center Frankfurt, Frankfurt, Germany (H.E.); University Heart Center Leipzig, Leipzig, Germany (D.S.); German Heart Institute Berlin, Berlin, Germany (B.Z.); the Centre Hospitalière Universitaire, Hôpital de Rangueil, Toulouse, France (H.R.); the Universitá St. Orsola Malpighi, Bologna, Italy (R.F.); the Department of Cardiovascular Surgery,...
  • Dierk Scheinert
    From the University of Rostock, Heart Center and Institute for Biostatistics, Rostock, Germany (C.A.N., S.K., T.C.R., G.K., A.G., T.K., H.I.); CCB Heart Center Frankfurt, Frankfurt, Germany (H.E.); University Heart Center Leipzig, Leipzig, Germany (D.S.); German Heart Institute Berlin, Berlin, Germany (B.Z.); the Centre Hospitalière Universitaire, Hôpital de Rangueil, Toulouse, France (H.R.); the Universitá St. Orsola Malpighi, Bologna, Italy (R.F.); the Department of Cardiovascular Surgery,...
  • Martin Czerny
    From the University of Rostock, Heart Center and Institute for Biostatistics, Rostock, Germany (C.A.N., S.K., T.C.R., G.K., A.G., T.K., H.I.); CCB Heart Center Frankfurt, Frankfurt, Germany (H.E.); University Heart Center Leipzig, Leipzig, Germany (D.S.); German Heart Institute Berlin, Berlin, Germany (B.Z.); the Centre Hospitalière Universitaire, Hôpital de Rangueil, Toulouse, France (H.R.); the Universitá St. Orsola Malpighi, Bologna, Italy (R.F.); the Department of Cardiovascular Surgery,...
  • Tilo Kleinfeldt
    From the University of Rostock, Heart Center and Institute for Biostatistics, Rostock, Germany (C.A.N., S.K., T.C.R., G.K., A.G., T.K., H.I.); CCB Heart Center Frankfurt, Frankfurt, Germany (H.E.); University Heart Center Leipzig, Leipzig, Germany (D.S.); German Heart Institute Berlin, Berlin, Germany (B.Z.); the Centre Hospitalière Universitaire, Hôpital de Rangueil, Toulouse, France (H.R.); the Universitá St. Orsola Malpighi, Bologna, Italy (R.F.); the Department of Cardiovascular Surgery,...
  • Burkhart Zipfel
    From the University of Rostock, Heart Center and Institute for Biostatistics, Rostock, Germany (C.A.N., S.K., T.C.R., G.K., A.G., T.K., H.I.); CCB Heart Center Frankfurt, Frankfurt, Germany (H.E.); University Heart Center Leipzig, Leipzig, Germany (D.S.); German Heart Institute Berlin, Berlin, Germany (B.Z.); the Centre Hospitalière Universitaire, Hôpital de Rangueil, Toulouse, France (H.R.); the Universitá St. Orsola Malpighi, Bologna, Italy (R.F.); the Department of Cardiovascular Surgery,...
  • Louis Labrousse
    From the University of Rostock, Heart Center and Institute for Biostatistics, Rostock, Germany (C.A.N., S.K., T.C.R., G.K., A.G., T.K., H.I.); CCB Heart Center Frankfurt, Frankfurt, Germany (H.E.); University Heart Center Leipzig, Leipzig, Germany (D.S.); German Heart Institute Berlin, Berlin, Germany (B.Z.); the Centre Hospitalière Universitaire, Hôpital de Rangueil, Toulouse, France (H.R.); the Universitá St. Orsola Malpighi, Bologna, Italy (R.F.); the Department of Cardiovascular Surgery,...
  • Rossella Fattori
    From the University of Rostock, Heart Center and Institute for Biostatistics, Rostock, Germany (C.A.N., S.K., T.C.R., G.K., A.G., T.K., H.I.); CCB Heart Center Frankfurt, Frankfurt, Germany (H.E.); University Heart Center Leipzig, Leipzig, Germany (D.S.); German Heart Institute Berlin, Berlin, Germany (B.Z.); the Centre Hospitalière Universitaire, Hôpital de Rangueil, Toulouse, France (H.R.); the Universitá St. Orsola Malpighi, Bologna, Italy (R.F.); the Department of Cardiovascular Surgery,...
  • Hüseyin Ince
    From the University of Rostock, Heart Center and Institute for Biostatistics, Rostock, Germany (C.A.N., S.K., T.C.R., G.K., A.G., T.K., H.I.); CCB Heart Center Frankfurt, Frankfurt, Germany (H.E.); University Heart Center Leipzig, Leipzig, Germany (D.S.); German Heart Institute Berlin, Berlin, Germany (B.Z.); the Centre Hospitalière Universitaire, Hôpital de Rangueil, Toulouse, France (H.R.); the Universitá St. Orsola Malpighi, Bologna, Italy (R.F.); the Department of Cardiovascular Surgery,...

書誌事項

タイトル別名
  • Long-term Results of the Randomized Investigation of Stent Grafts in Aortic Dissection Trial
公開日
2013-08
DOI
  • 10.1161/circinterventions.113.000463
公開者
Ovid Technologies (Wolters Kluwer Health)

この論文をさがす

説明

<jats:sec> <jats:title>Background—</jats:title> <jats:p>Thoracic endovascular aortic repair (TEVAR) represents a therapeutic concept for type B aortic dissection. Long-term outcomes and morphology after TEVAR for uncomplicated dissection are unknown.</jats:p> </jats:sec> <jats:sec> <jats:title>Methods and Results—</jats:title> <jats:p> A total of 140 patients with stable type B aortic dissection previously randomized to optimal medical treatment and TEVAR (n=72) versus optimal medical treatment alone (n=68) were analyzed retrospectively for aorta-specific, all-cause outcomes, and disease progression using landmark statistical analysis of years 2 to 5 after index procedure. Cox regression was used to compare outcomes between groups; all analyses are based on intention to treat. The risk of all-cause mortality (11.1% versus 19.3%; <jats:italic>P</jats:italic> =0.13), aorta-specific mortality (6.9% versus 19.3%; <jats:italic>P</jats:italic> =0.04), and progression (27.0% versus 46.1%; <jats:italic>P</jats:italic> =0.04) after 5 years was lower with TEVAR than with optimal medical treatment alone. Landmark analysis suggested a benefit of TEVAR for all end points between 2 and 5 years; for example, for all-cause mortality (0% versus 16.9%; <jats:italic>P</jats:italic> =0.0003), aorta-specific mortality (0% versus 16.9%; <jats:italic>P</jats:italic> =0.0005), and for progression (4.1% versus 28.1%; <jats:italic>P</jats:italic> =0.004); Landmarking at 1 year and 1 month revealed consistent findings. Both improved survival and less progression of disease at 5 years after elective TEVAR were associated with stent graft induced false lumen thrombosis in 90.6% of cases ( <jats:italic>P</jats:italic> <0.0001). </jats:p> </jats:sec> <jats:sec> <jats:title>Conclusions—</jats:title> <jats:p>In this study of survivors of type B aortic dissection, TEVAR in addition to optimal medical treatment is associated with improved 5-year aorta-specific survival and delayed disease progression. In stable type B dissection with suitable anatomy, preemptive TEVAR should be considered to improve late outcome.</jats:p> </jats:sec> <jats:sec> <jats:title>Clinical Trial Registration—</jats:title> <jats:p> URL: <jats:ext-link xmlns:xlink="http://www.w3.org/1999/xlink" ext-link-type="uri" xlink:href="http://www.clinicaltrials.gov">http://www.clinicaltrials.gov</jats:ext-link> . Unique identifier: NCT01415804. </jats:p> </jats:sec>

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