Analysis Of Aortic Remodeling After Distal Restrictive Stent Graft After TEVAR In Type B Aortic Dissection

Objective: To explore the effect of thoracic aortic endovascular repair(TEVAR)combined with a restrictive stent graft(Cuff)placed in the distal landing area for the treatment of Stanford B-type aortic dissection and the effect of remodeling.Methods:Collect 61 cases of clinical data and imaging data in patients with type B aortic dissection January 2018 to April 2020 TEVAR receiving treatment at the Center and analyzed retrospectively.24patients(39.3%)Cuff technique employed for the treatment TEVAR,2cm below the opening plane according to the selected level of the descending aorta dissected subclavian artery,pulmonary plane,the plane of the lower edge of the left atrium,celiac level measurement plane,the measurement plane of each of the main Aortic diameter changes such as the maximum diameter of the artery,the short diameter of the true lumen,the long diameter of the true lumen,the short diameter of the false lumen,and the long diameter of the false lumen.The two groups were compared with the aortic morphology and combined with the degree of thrombosis of the aortic false lumen.The remodeling of the aorta is explored.Results:In all 61 cases the follow-up time was 12.3 ± 2.6 months.A total of 9 adverse events occurred during the follow-up period,including 2 cases of distal stent re-rupture,1case of postoperative renal function exacerbation,4 cases of lower limb ischaemia,1 case of endoleak and 1 column of visceral artery embolism.Compared with the TEVAR group,there were differences in the amount of true lumen short diameter change in the Cuff group in the pulmonary artery plane(P < 0.05),the inferior border plane of the left atrium(P < 0.05),and the abdominal trunk plane(P < 0.05);there were differences in the amount of sham lumen short diameter change(P < 0.05)and long diameter change(P <0.05)in the abdominal trunk plane;comparison of the degree of complete thrombosis of the sham lumen between the two groups: stent The thrombosis rate was higher in the Cuff group than in the TEVAR group,but there was no statistical difference between the two groups.Conclusion:1.Compared with the standard TEVAR operation,the combined restrictive stent graft(Cuff)implantation is beneficial to the expansion of the true cavity at the level of the abdominal trunk,which can promote the reduction of the false cavity and the complete thrombosis of the false cavity,but these require larger samples and more A prospective study with a long follow-up time further confirmed its effectiveness.2.Follow-up observation can actively discover new stentderived distal tears and reduce the occurrence of adverse events such as aortic rupture;...