In Patients with a Chronic Type B Dissection, Does Endovascular Treatment Reduce Long Term Complications?


P (patients)

I (intervention)

C (comparator group)

O (outcomes measured)

Patients with Chronic Type B dissection

Endovascular treatment

Medical management (for uncomplicated type B dissection)

Open surgical repair (complicated type B dissection)

30 day mortality, early CVA and spinal cord ischemia (SCI), long-term survival, aortic event-free survival and rate of aortic re-interventions.




Table 2.2
Results for TEVAR in chronic complicated Type B aortic dissection




































































































Author, year (ref.#)
n
30 day mortality N (%)
Early CVA N (%)
Early SCI N (%)
Mean f/up (m)
Survival (%)
Aortic event freedom rate
 
Aorta related death, reintervention, expansion free (%)
Aorta related death free (%)

Prospective nonrandomized trials

Virtue registry (2011, 2014) [10, 11]
50
0
0
1 (3.8)
36
1 year: 96

3 years: 74
1 year: 88

3 years: 68
1 year: 91.3

3 years: 74

Case series

Alves (2009) [13]
61
2 (3.3)
0
0
35.9
3 years: 94
3 years: 78
n/a

Parsa (2011) [16]
51
0
0
0
27
5 years: 77.7
5 years:77.3
5 years: 98

Kang (2011) [17]
76
4 (5)
1 (1.3)
0
34
1 year: 86

3 years: 80
1 year: 72

3 years: 59
1 year: 89

3 years: 86

Andacheh (2012) [18]
73
10 (14)
1 (1.3)
1 (1.3)
18
1 year: 81
1 year: 85
1 year: 86

Mani (2012) [19]
58
3 (5.2)
0
1 (1.7)
n/a
1 year: 89

3 years: 64
1 year: 85

3 years: 71
  

Cumulative
369
5.6 %
0.4 %
1.1 %
      


SCI spinal cord ischemia, CVA cerebral vascular accident, f/up follow up



Table 2.3
Results for medical treatment in chronic uncomplicated Type B aortic dissection



































































Author, year (ref.#)
n
30 days mortality N (%)
Early CVA N (%)
Early SCI N (%)
Mean f/up (m)
Survival (%)
Aortic event freedom rate
             
Aorta related death, reintervention, expansion free (%)
Aorta related death free (%)

Prospective randomized controlled trials

Nienaber INSTEAD (2009, 2013) [8, 9]
68
0
0
0
69
1 year: 82.5

15 years: 80.7 years: 97
1 year: 82.5

5 years: 53.9
1 year: 97

5 years: 80.7

Prospective nonrandomized trials

Jia (2013) [12]
68
0
0
0
69
1 year: 97

5 years: 80.7
1 year: 82.5

5 years: 53.9
1 year: 97

5 years: 80.7

Cumulative
163
0
0
0
        



Table 2.4
Results for TEVAR in chronic uncomplicated Type B aortic dissection





























































































Author, year (ref.#)
n
30 days mortality N (%)
Early CVA N (%)
Early SCI N (%)
Mean f/up (m)
Survival (%)
Aortic event freedom rate
             
Aorta related death, reintervention, expansion free (%)
Aorta related death free (%)

Prospective randomized controlled trials

Nienaber INSTEAD (2009, 2013) [8, 9]
72
2 (2.8)
1 (1.4)
2 (2.9)
69
1 year: 91.3

5 years: 91.3
1 year: 83.3

5 years: 73
1 year: 94.2

5 years: 93.1

Prospective nonrandomized trials

Zipfel Restore registry (2011) [20]
51
3 (5)
0
2 (3.9)
10
N/a
n/a
n/a

Jia (2013) [12]
208
0
0
2 (0.9)
28.5
2 years: 87.5

4 years: 82.7
2 years: 87.8

4 years: 78.8
2 years: 91.6

4 years: 88.1

Case series

Kim (2009) [14]
72
0
0
0
64.4
5 years: 92
5 years: 83.9
5 years: 98.3

Xu (2009) [15]
84
1 (1.2)
0
0
33.2
3 years: 91.7
5 years: 84.4
7 years: 75.2

Kim (2009) [14]
72
0

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Oct 11, 2017 | Posted by in CARDIOLOGY | Comments Off on In Patients with a Chronic Type B Dissection, Does Endovascular Treatment Reduce Long Term Complications?

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