The beneficial enlightenment of thoracic endovascular aortic repair for traumatic type B aortic dissection with long-term follow-up of single center

Abstract

Objective To evaluate the long-term clinical effect of Thoracic endovascular aortic repair (TEVAR) for traumatic Type B aortic dissection, and to provide a reference for the next stage treatment. Methods Twenty-one patients with traumatic Stanford type B aortic dissection treated in our center from December 1999 to June 2012 were retrospectively analyzed for the treatment effectiveness and follow-up results. The average age of 21 Traumatic Type B aortic dissection patients was 42.7 years (range: 19 to 67 years). Men accounted for 85.7% (18/21). 80.9% (17/21) of the dissection were caused by car accident, 4 were due to falling accident from high places. There were 7 cases of hypertension, 4 cases of diabetes, 4 cases of hyperlipidemia, 2 cases of chronic ischemic heart disease, 14 cases of pneumothorax, 8 cases of rib fracture, 3 cases of craniocerebral trauma / neuropsychiatric symptoms, and 1 patient with shock. The median time from onset to treatment was 5 days (range: 1-73 days). There were 16 cases (≤14 days) in the acute phase, 2 cases (15-60 days) in the subacute phase, and 3 cases (> 60 days) in the chronic phase. There was no patient in super acute phase in the study group (0-24 hour). Results The perioperative mortality was 9.52% (2/21) for the patients traumatic type B aortic dissection, 4.76% (1/21) for those with postoperative endoleaks; 2-year and 5-year survival rates were 90.48% and 85.71%. Conclusion Intracavitary treatment of traumatic Stanford B type aortic dissection is effective and has good long-term clinical benefit, which provides a guidance for future clinical treatment of traumatic type B aortic dissection. Key words: Type B aortic dissection; Thoracic endovascular aortic repair; Trauma