DOI QR코드

DOI QR Code

Endovascular Repair in Acute Complicated Type B Aortic Dissection: 3-Year Results from the Valiant US Investigational Device Exemption Study

  • Lim, Chang Young (Department of Thoracic and Cardiovascular Surgery, Andong General Hospital)
  • 투고 : 2017.04.20
  • 심사 : 2017.05.11
  • 발행 : 2017.06.05

초록

Acute complicated type B aortic dissection (TBAD) is a potentially catastrophic, life-threatening condition. If left untreated, there is a high risk of aortic rupture, irreversible organ or limb damage, or death. Several risk factors have been associated with acute complicated TBAD, including age and refractory hypertension. In the acute phase, even uncomplicated patients are more prone to develop complications if hypertension and pain are left medically untreated. Innovations in stent graft technologies have incrementally improved outcomes since their first use for this condition in 1999, though improvement is needed in mitigating periprocedural complications, adverse events, and mortality. In the past decade, endovascular repair has become the preferred treatment because of its superior outcomes to open repair and medical therapy. The Valiant Captivia Thoracic Stent Graft System is a third-generation endovascular stent graft with advancements in minimally invasive delivery, conformability to the anatomy, and the minimization of adverse sequelae. Herein, this stent graft is briefly reviewed and its 3-year outcomes are presented. Freedom from all-cause and dissection-related mortality was 79.1% and 90.0%, respectiv ely. The Valiant Captiv ia Stent Graft represents a safe, effective intervention for acute complicated TBAD. Continued surveillance is needed to verify its longer-term durability.

키워드

참고문헌

  1. Hagan PG, Nienaber CA, Isselbacher EM, et al. The International Registry of Acute Aortic Dissection (IRAD): new insights into an old disease. JAMA 2000;283:897-903. https://doi.org/10.1001/jama.283.7.897
  2. Sakakura K, Kubo N, Ako J, et al. Determinants of in-hospital death and rupture in patients with a Stanford B aortic dissection. Circ J 2007;71:1521-4. https://doi.org/10.1253/circj.71.1521
  3. Trimarchi S, Tolenaar JL, Tsai TT, et al. Influence of clinical presentation on the outcome of acute B aortic dissection: evidences from IRAD. J Cardiovasc Surg (Torino) 2012;53:161-8.
  4. Trimarchi S, Nienaber CA, Rampoldi V, et al. Role and results of surgery in acute type B aortic dissection: insights from the International Registry of Acute Aortic Dissection (IRAD). Circulation 2006;114(1 Suppl):I357-64. https://doi.org/10.1161/CIRCULATIONAHA.105.600627
  5. Estrera AL, Miller CC, Goodrick J, et al. Update on outcomes of acute type B aortic dissection. Ann Thorac Surg 2007;83:S842-5. https://doi.org/10.1016/j.athoracsur.2006.10.081
  6. Uchida N, Shibamura H, Katayama A, Aishin K, Sutoh M, Kuraoka M. Surgical strategies for organ malperfusions in acute type B aortic dissection. Interact Cardiovasc Thorac Surg 2009;8:75-8.
  7. Trimarchi S, Tolenaar JL, Jonker FH, et al. Importance of false lumen thrombosis in type B aortic dissection prognosis. J Thorac Cardiovasc Surg 2013;145(3 Suppl): S208-12. https://doi.org/10.1016/j.jtcvs.2012.11.048
  8. Tsai TT, Evangelista A, Nienaber CA, et al. Partial thrombosis of the false lumen in patients with acute type B aortic dissection. N Engl J Med 2007;357:349-59. https://doi.org/10.1056/NEJMoa063232
  9. Song JM, Kim SD, Kim JH, et al. Long-term predictors of descending aorta aneurysmal change in patients with aortic dissection. J Am Coll Cardiol 2007;50:799-804. https://doi.org/10.1016/j.jacc.2007.03.064
  10. Bockler D, Schumacher H, Ganten M, et al. Complications after endovascular repair of acute symptomatic and chronic expanding Stanford type B aortic dissections. J Thorac Cardiovasc Surg 2006;132:361-8. https://doi.org/10.1016/j.jtcvs.2006.02.056
  11. Jonker FH, Trimarchi S, Muhs BE, et al. The role of age in complicated acute type B aortic dissection. Ann Thorac Surg 2013;96:2129-34. https://doi.org/10.1016/j.athoracsur.2013.06.056
  12. Harris KM, Braverman AC, Eagle KA, et al. Acute aortic intramural hematoma: an analysis from the International Registry of Acute Aortic Dissection. Circulation 2012; 126(11 Suppl 1):S91-6. https://doi.org/10.1161/CIRCULATIONAHA.111.084541
  13. Collins JS, Evangelista A, Nienaber CA, et al. Differences in clinical presentation, management, and outcomes of acute type a aortic dissection in patients with and without previous cardiac surgery. Circulation 2004;110(11 Suppl 1):II237-42.
  14. Charilaou P, Ziganshin BA, Peterss S, et al. Current experience with acute type B aortic dissection: validity of the complication-specific approach in the present era. Ann Thorac Surg 2016;101:936-43. https://doi.org/10.1016/j.athoracsur.2015.08.074
  15. Dake MD, Kato N, Mitchell RS, et al. Endovascular stent-graft placement for the treatment of acute aortic dissection. N Engl J Med 1999;340:1546-52. https://doi.org/10.1056/NEJM199905203402004
  16. Nienaber CA, Fattori R, Lund G, et al. Nonsurgical reconstruction of thoracic aortic dissection by stent-graft placement. N Engl J Med 1999;340:1539-45. https://doi.org/10.1056/NEJM199905203402003
  17. Fattori R, Cao P, De Rango P, et al. Interdisciplinary expert consensus document on management of type B aortic dissection. J Am Coll Cardiol 2013;61:1661-78. https://doi.org/10.1016/j.jacc.2012.11.072
  18. Miller DC, Mitchell RS, Oyer PE, Stinson EB, Jamieson SW, Shumway NE. Independent determinants of operative mortality for patients with aortic dissections. Circulation 1984;70(3 Pt 2):I153-64. https://doi.org/10.1161/01.CIR.70.2.153
  19. Hogendoorn W, Hunink MG, Schlosser FJ, Moll FL, Sumpio BE, Muhs BE. Endovascular vs. open repair of complicated acute type B aortic dissections. J Endovasc Ther 2014; 21:503-14. https://doi.org/10.1583/14-4716R.1
  20. Ehrlich MP, Rousseau H, Heijmen R, et al. Midterm results after endovascular treatment of acute, complicated type B aortic dissection: the Talent Thoracic Registry. J Thorac Cardiovasc Surg 2013;145:159-65. https://doi.org/10.1016/j.jtcvs.2011.10.093
  21. Fattori R, Tsai TT, Myrmel T, et al. Complicated acute type B dissection: is surgery still the best option?: a report from the International Registry of Acute Aortic Dissection. JACC Cardiovasc Interv 2008;1:395-402. https://doi.org/10.1016/j.jcin.2008.04.009
  22. Fattori R, Montgomery D, Lovato L, et al. Survival after endovascular therapy in patients with type B aortic dissection: a report from the International Registry of Acute Aortic Dissection (IRAD). JACC Cardiovasc Interv 2013;6: 876-82. https://doi.org/10.1016/j.jcin.2013.05.003
  23. Nauta FJ, Trimarchi S, Kamman AV, et al. Update in the management of type B aortic dissection. Vasc Med 2016; 21:251-63. https://doi.org/10.1177/1358863X16642318
  24. Parsa CJ, Schroder JN, Daneshmand MA, McCann RL, Hughes GC. Midterm results for endovascular repair of complicated acute and chronic type B aortic dissection. Ann Thorac Surg 2010;89:97-102. https://doi.org/10.1016/j.athoracsur.2009.09.029
  25. Shu C, He H, Li QM, Li M, Jiang XH, Luo MY. Endovascular repair of complicated acute type-B aortic dissection with stentgraft: early and mid-term results. Eur J Vasc Endovasc Surg 2011;42:448-53. https://doi.org/10.1016/j.ejvs.2011.05.013
  26. Pearce BJ, Passman MA, Patterson MA, et al. Early outcomes of thoracic endovascular stent-graft repair for acute complicated type B dissection using the Gore TAG endoprosthesis. Ann Vasc Surg 2008;22:742-9. https://doi.org/10.1016/j.avsg.2008.08.035
  27. Chemelli-Steingruber I, Chemelli A, Strasak A, et al. Endovascular repair or medical treatment of acute type B aortic dissection?: a comparison. Eur J Radiol 2010;73: 175-80. https://doi.org/10.1016/j.ejrad.2008.09.031
  28. Heijmen RH, Thompson MM, Fattori R, Goktay Y, Teebken OE, Orend KH. Valiant thoracic stent-graft deployed with the new captivia delivery system: procedural and 30-day results of the Valiant Captivia Registry. J Endovasc Ther 2012;19:213-25. https://doi.org/10.1583/11-3652MR.1
  29. Ruan ZB, Zhu L, Yin YG, Chen GC. Risk factors of early and late mortality after thoracic endovascular aortic repair for complicated Stanford B acute aortic dissection. J Card Surg 2014;29:501-6. https://doi.org/10.1111/jocs.12377
  30. Sayer D, Bratby M, Brooks M, Loftus I, Morgan R, Thompson M. Aortic morphology following endovascular repair of acute and chronic type B aortic dissection: implications for management. Eur J Vasc Endovasc Surg 2008;36:522-9. https://doi.org/10.1016/j.ejvs.2008.06.023
  31. Nienaber CA, Clough RE. Management of acute aortic dissection. Lancet 2015;385:800-11. https://doi.org/10.1016/S0140-6736(14)61005-9
  32. Conrad MF, Carvalho S, Ergul E, et al. Late aortic remodeling persists in the stented segment after endovascular repair of acute complicated type B aortic dissection. J Vasc Surg 2015;62:600-5. https://doi.org/10.1016/j.jvs.2015.03.064
  33. Singh M, Hager E, Avgerinos E, Genovese E, Mapara K, Makaroun M. Choosing the correct treatment for acute aortic type B dissection. J Cardiovasc Surg (Torino) 2015; 56:217-29.
  34. Minami T, Imoto K, Uchida K, et al. Clinical outcomes of emergency surgery for acute type B aortic dissection with rupture. Eur J Cardiothorac Surg 2013;44:360-4. https://doi.org/10.1093/ejcts/ezs703
  35. Kokotsakis J, Kaskarelis I, Misthos P, et al. Endovascular versus open repair for blunt thoracic aortic injury: short-term results. Ann Thorac Surg 2007;84:1965-70. https://doi.org/10.1016/j.athoracsur.2007.07.061
  36. Buz S, Zipfel B, Mulahasanovic S, Pasic M, Weng Y, Hetzer R. Conventional surgical repair and endovascular treatment of acute traumatic aortic rupture. Eur J Cardiothorac Surg 2008;33:143-9. https://doi.org/10.1016/j.ejcts.2007.10.017
  37. Zeeshan A, Woo EY, Bavaria JE, et al. Thoracic endovascular aortic repair for acute complicated type B aortic dissection: superiority relative to conventional open surgical and medical therapy. J Thorac Cardiovasc Surg 2010;140(6 Suppl):S109-15. https://doi.org/10.1016/j.jtcvs.2010.06.024
  38. Zhu Y, Wang B, Meng Q, Liu J, Zhai S, He J. Long-term efficacy of endovascular vs open surgical repair for complicated type-B aortic dissection: a single-center retrospective study and meta-analysis. Braz J Med Biol Res 2016;49:e5194.
  39. Dong Z, Fu W, Wang Y, et al. Stent graft-induced new entry after endovascular repair for Stanford type B aortic dissection. J Vasc Surg 2010;52:1450-7. https://doi.org/10.1016/j.jvs.2010.05.121
  40. Weng SH, Weng CF, Chen WY, et al. Reintervention for distal stent graft-induced new entry after endovascular repair with a stainless steel-based device in aortic dissection. J Vasc Surg 2013;57:64-71. https://doi.org/10.1016/j.jvs.2012.07.006
  41. Jang H, Kim MD, Kim GM, et al. Risk factors for stent graft-induced new entry after thoracic endovascular aortic repair for Stanford type B aortic dissection. J Vasc Surg 2017;65:676-85. https://doi.org/10.1016/j.jvs.2016.09.022
  42. Chen IM, Huang CY, Weng SH, et al. Implantation sequence modification averts distal stent graft-induced new entry after endovascular repair of Stanford type B aortic dissection. J Vasc Surg 2016;64:281-8. https://doi.org/10.1016/j.jvs.2016.02.032
  43. Bavaria JE, Brinkman WT, Hughes GC, et al. Outcomes of thoracic endovascular aortic repair in acute type B aortic dissection: results from the Valiant United States Investigational Device Exemption Study. Ann Thorac Surg 2015;100:802-8. https://doi.org/10.1016/j.athoracsur.2015.03.108
  44. Fairman RM, Tuchek JM, Lee WA, et al. Pivotal results for the Medtronic Valiant Thoracic Stent Graft System in the VALOR II trial. J Vasc Surg 2012;56:1222-31. https://doi.org/10.1016/j.jvs.2012.04.062
  45. Matsumoto AH, Angle JF, Secic M, Carlson GA, Fisher L, Fairman RM. Secondary procedures following thoracic aortic stent grafting in the first 3 years of the VALOR test and VALOR II trials. J Vasc Interv Radiol 2014;25:685-92. https://doi.org/10.1016/j.jvir.2013.12.012
  46. VIRTUE Registry Investigators. Mid-term outcomes and aortic remodelling after thoracic endovascular repair for acute, subacute, and chronic aortic dissection: the VIRTUE Registry. Eur J Vasc Endovasc Surg 2014;48:363-71. https://doi.org/10.1016/j.ejvs.2014.05.007
  47. Patterson BO, Vidal-Diez A, Karthikesalingam A, Holt PJ, Loftus IM, Thompson MM. Comparison of aortic diameter and area after endovascular treatment of aortic dissection. Ann Thorac Surg 2015;99:95-102. https://doi.org/10.1016/j.athoracsur.2014.08.022
  48. Brooks M, Loftus I, Morgan R, Thompson M. The Valiant thoracic endograft. J Cardiovasc Surg (Torino) 2006;47: 269-78.
  49. Khoynezhad A, Donayre CE, Azizzadeh A, White R; RESCUE investigators. One-year results of thoracic endovascular aortic repair for blunt thoracic aortic injury (RESCUE trial). J Thorac Cardiovasc Surg 2015;149:155-61. https://doi.org/10.1016/j.jtcvs.2014.09.026
  50. Khoynezhad A, Azizzadeh A, Donayre CE, et al. Results of a multicenter, prospective trial of thoracic endovascular aortic repair for blunt thoracic aortic injury (RESCUE trial). J Vasc Surg 2013;57:899-905 https://doi.org/10.1016/j.jvs.2012.10.099
  51. Roselli EE, Arko FR 3rd, Thompson MM; Valiant Mona LSA Trial Investigators. Results of the Valiant Mona LSA early feasibility study for descending thoracic aneurysms. J Vasc Surg 2015;62:1465-71. https://doi.org/10.1016/j.jvs.2015.07.078

피인용 문헌

  1. Treatment experience of thoracic aortic aneurysm recurrence after multiple surgeries for Marfan syndrome : A case report vol.98, pp.40, 2017, https://doi.org/10.1097/md.0000000000017391
  2. Open stented elephant trunk for complicated Stanford type B aortic dissection: a single-center experience vol.15, pp.1, 2020, https://doi.org/10.1186/s13019-020-01341-6
  3. TEVAR for complicated and uncomplicated type B aortic dissection-Systematic review and meta‐analysis vol.36, pp.10, 2017, https://doi.org/10.1111/jocs.15827