Aortic Remodeling After Endovascular Repair Of Stanford Type B Aortic Dissection

Objective : To explore the aortic dissecting aortic remodeling process after TEVAR Stanford B type, analysizing different factors acting on aortic remodeling, in order to put forward a more reasonable clinical treatment strategies.Methods: Retrospectively analysizing 28 Stanford type B aortic dissection cases in our hospital undergoing TEVAR operation from January 2013 to January 2015, Collecting patients’ general information, according to the course of the disease, less than 14 days called the acute dissection group; Course of the disease within 14 days to 60 days called the subacute group; More than 60 days called the chronic group. Computed tomography angiography(CTA) is the main way of preoperative diagnosis and postoperative follow-up, measuring the level of left subclavian artery opening, pulmonary artery, celiac axis and abdominal aortic bifurcation,observing the situation of leakage,the number of crevasses and measuring of true and false lumen diameter changes, etc.Result: In the whole of 28 cases, there are 22 men and 6 women. TEVAR postoperative follow-up showed that the expansion of the stent section of the aorta is the largest, distal section of the aortic stent is in the second place, abdominal aorta increases the smallest. False lumen of stents section of aorta decreases sharply, distal thoracic aorta decreases smaller, and the false lumen of abdominal aorta is not obviously decreasing or even increasing, including 1 case appearing false cavity expansion markedly. Acute dissection group and subacute group is obviously better than the chronic group in false lumen remolding. Postoperative residual breaches are 2.31(0-6) on average, the rate of appearing distal stent graft-induced new entry in acute group is 14.3%, there is no finding in subacute and chronic group, the P value is less than 0.05.Conclusion: 1. The endovascular repair of Stanford type B aortic dissection can significantly increase the survival rate of patients and postoperative quality of life;2. The remodeling of stent section of the aorta is the best, that of distal thoracic aorta is not so obviously, that of abdominal aorta is the worst.3. The remodeling of chronic group is inferior to acute dissection and subacute dissection group;...