The effect of the extent of the stent graft coverage of the aorta on the remodeling of the distal false lumen after thoracic endovascular aortic repair for non-traumatic type IIIB dissections.

Abstract

We aimed to evaluate the effect of length of stent-graft coverage of the aorta on the remodeling of the distal false lumen (DFL) to the stented segment (in the uncovered aorta) after thoracic endovascular aortic repair (TEVAR) for acute complicated non-traumatic type IIIB aortic dissections. Retrospective analysis of 25 consecutive patients (mean age 48 years, 19 males), who underwent TEVAR with a single device and whose 1-year follow-up computed tomography (CT) data was available, was performed. There was no significant difference between the percentage of distal false lumen thrombosis or false lumen volume post procedure between those who had < 50% length coverage (n = 11) versus those who had = / > 50% length coverage (n = 14) of aorta (p = 0.665 and 0.571, respectively). The percent length of aortic coverage showed a negative linear correlation with change in the DFL-thrombosis post-TEVAR (r = - 0.603, p = 0.001); however, it did not correlate with change in the DFL-volume (r = - 0.07, p = 0.84). From the data in our study, it appears that false lumen thrombosis decreases as the length of stent graft increases at 12 months, contrary to current knowledge. Further studies are required to confirm such an observation.