Follow-up And Clinical Study Of Aortic Remodeling In Stanford Type B Aortic Dissection With Endovascular Graft Exclusion

Objective:to compare the postoperative conditions of the aortic remodeling in patients with Type B aortic dissection underwent drug treatment and endovascular treatment, and to elucidate the characteristics of aortic remodeling and true and false lumen underwent EVGE.Methods:We retrospectively studied103patients who had been treated from2004to2011, combing with their preoperative and postoperative CTA and follow-up data. We compared the differences of hospital mortality, and survival rate between drug treatment and endovascular treatment, and measured the diameter of the true and false lumen of preoperative and postoperative aortic dissection on four different planes, to elucidate the characteristics of aortic remodeling and true and false lumen underwent EVGE in term of the timing of treatment, stent type of preoperative false lumen with or without thrombosis and so on.Results:Compared with the drug treatment group, the hospital mortality and complication rate in endovascular treatment group is lower (P<0.05), and1-year and3-year survival rate is higher (P<0.05). Stanford type B aortic dissection patients with descending aortic diameter from proximal to distal (P <0.05), the true lumen was increased significantly after Endovascular exclusion, and the false lumen was significantly reduced (P<0.05). There is no significant difference when surgery in the acute phase and chronic phase on true and false lumen (P>0.05). Aortic dilatation is more serious when using the straight-type stents compared with tapered stents in the level of the stent distal level(P<0.05). The patients without preoperative false lumen thrombosis have significantly reduced in postoperative false lumen(P<0.05).Conclusion:For Standford type B aortic dissection, endovascular surgery has a high technical success rate, and its1-year and3-year survival rate was significantly superior to drug therapy. After endovascular exclusion, the true lumen expansion, false lumen shrink, false lumen thrombosis. No significant difference between acute and chronic phase of endovascular treatment of postoperative aortic remodeling, tapered stents and preoperative primary break without thrombosis conducive to aortic remodeling.