Application of Unibody Single-Branch Endografts in Stanford Type B Dissections with Primary Entry Tear Adjacent to the Left Subclavian Artery: A Computed Tomography–Based Planning Study
In: Annals of Vascular Surgery, Jg. 29 (2015-08-01), S. 1174-1180
Online
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Zugriff:
Background A custom-made unibody single-branch endograft (USBE) could provide great gains in the landing zone, while maintaining a left subclavian artery (LSA) perfusion in some patients with Stanford type B dissections (TBADs). We performed a computed tomography (CT)-based planning study to determine the proportion of TBAD patients who could benefit from this custom-made USBE and ascertained the possibility of an off-the-shelf USBE in an emergency setting. Methods We carried out a retrospective study of TBAD patients with optimal CT scans at our center from 2007 to 2013. Patients' CT scans were analyzed using 3-dimensional reconstruction software. After generating a centerline of flow, measurements (including numerous morphologic characteristics of anatomy) were evaluated. A selected subset of patients suitable for USBE was determined. Finally, the most frequently used configurations of endografts were figured out by subgroup analysis. Results A total of 314 patients with optimal digital imaging communications in medicine (DICOM) data were included in our study. The main primary entry tears (MPETs) were located at 22.8 ± 17.3 and 36.3 ± 18.6 mm distal to the LSA and the left common carotid artery, respectively. Overall, 169 (54.2%) patients with MPET distal to LSA (>20 mm) could be treated by tubular stent grafts. Of the 143 patients who had intimal tears adjacent to the LSA (≤20 mm), there were 111 (35.4%) patients who could benefit from treatment using USBE based on our selection criteria. Subgroup analysis estimated the number of graft configurations needed to treat a proportion of patients: 1 design would treat 6.7% of the population, 5 designs would treat 23.1%, 10 designs would treat 37.6%, and 20 configurations would treat 54.8% . Conclusions In all, 35.4% patients with TBAD could potentially benefit from USBE. The use of off-the-shelf endografts might be possible in cases of emergency, given the evidence of recurrent configurations.
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Application of Unibody Single-Branch Endografts in Stanford Type B Dissections with Primary Entry Tear Adjacent to the Left Subclavian Artery: A Computed Tomography–Based Planning Study
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Autor/in / Beteiligte Person: | Liu, Changjian ; Huang, Dian ; Liu, Zhao ; Zhou, Min ; Qiao, Tong ; Huang, Chen |
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Zeitschrift: | Annals of Vascular Surgery, Jg. 29 (2015-08-01), S. 1174-1180 |
Veröffentlichung: | Elsevier BV, 2015 |
Medientyp: | unknown |
ISSN: | 0890-5096 (print) |
DOI: | 10.1016/j.avsg.2015.02.016 |
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