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- Publisher Website: 10.1016/j.avsg.2022.03.020
- Scopus: eid_2-s2.0-85128212947
- PMID: 35339592
- WOS: WOS:000881830700043
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Article: Methods and Outcomes of Endovascular False Lumen Embolization for Thoracic Aortic Dissection
Title | Methods and Outcomes of Endovascular False Lumen Embolization for Thoracic Aortic Dissection |
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Authors | |
Issue Date | 2022 |
Citation | Annals of Vascular Surgery, 2022, v. 85, p. 371-382 How to Cite? |
Abstract | Background: To provide a contemporary review on endovascular false lumen (FL) embolization for thoracic aortic dissection (AD) and evaluate its early outcome. Methods: A systematic literature review on FL embolization for thoracic AD from January 2003 to December 2020 was performed under the instruction of Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Each article was analyzed using a standardized protocol including predefined demographic characteristics, perioperative mortality, and major complications. Results: A total of 29 papers with 229 patients were included into the analysis. The methods of FL occlusion used were the candy-plug technique, the knickerbocker technique, the “cork in the bottleneck” technique, and direct FL embolization with a combination of stent-grafts, coils, onyx, plugs, and glue. FL embolization procedure was performed in 79 patients (34.5%) with type A AD and 150 (65.5%) with type B AD. FL direct embolization was the most frequently used technique and it was applied in 198 (86.5%) patients. Candy-plug, knickerbocker, and “cork in the bottleneck” techniques were used in 26 (11.4%), 3 (1.3%), and 2 (0.9%) patients, respectively. Technical success was achieved in all patients except one (228/229, 99.6%) in which implantation of a stent to celiac trunk was not possible. There were 4 hospital deaths (1.7%). Neurological complications occurred in 6 patients (2.6%), including 4 (1.7%) spinal cord ischemia and 2 (0.9%) ischemic stroke. There were 1 (0.4%) iatrogenic retrograde dissection and 2 (0.9%) renal failure reported. The mean duration of follow-up was 16.5 months. There were 21 deaths (9.3%) during follow-up and 8 (3.6%) were aorta-related. Thirty three (14.7%) secondary interventions were performed. Five patients (2.2%) required an open completion thoracoabdominal procedure incorporating the stent-graft into the repair. Complete FL thrombosis was observed in 181 (80.4%) patients, 34 (15.1%) had partial thrombosis, and 10 (4.4%) had FL progression. Conclusions: FL embolization of the distal thoracic aorta is a promising technique in a group of patients to promote FL thrombosis and aortic remodeling in thoracic aorta. |
Persistent Identifier | http://hdl.handle.net/10722/345181 |
ISSN | 2023 Impact Factor: 1.4 2023 SCImago Journal Rankings: 0.616 |
ISI Accession Number ID |
DC Field | Value | Language |
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dc.contributor.author | Li, Hai Lei | - |
dc.contributor.author | Chan, Yiu Che | - |
dc.contributor.author | Jia, He Yue | - |
dc.contributor.author | Cheng, Stephan W. | - |
dc.date.accessioned | 2024-08-15T09:25:45Z | - |
dc.date.available | 2024-08-15T09:25:45Z | - |
dc.date.issued | 2022 | - |
dc.identifier.citation | Annals of Vascular Surgery, 2022, v. 85, p. 371-382 | - |
dc.identifier.issn | 0890-5096 | - |
dc.identifier.uri | http://hdl.handle.net/10722/345181 | - |
dc.description.abstract | Background: To provide a contemporary review on endovascular false lumen (FL) embolization for thoracic aortic dissection (AD) and evaluate its early outcome. Methods: A systematic literature review on FL embolization for thoracic AD from January 2003 to December 2020 was performed under the instruction of Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Each article was analyzed using a standardized protocol including predefined demographic characteristics, perioperative mortality, and major complications. Results: A total of 29 papers with 229 patients were included into the analysis. The methods of FL occlusion used were the candy-plug technique, the knickerbocker technique, the “cork in the bottleneck” technique, and direct FL embolization with a combination of stent-grafts, coils, onyx, plugs, and glue. FL embolization procedure was performed in 79 patients (34.5%) with type A AD and 150 (65.5%) with type B AD. FL direct embolization was the most frequently used technique and it was applied in 198 (86.5%) patients. Candy-plug, knickerbocker, and “cork in the bottleneck” techniques were used in 26 (11.4%), 3 (1.3%), and 2 (0.9%) patients, respectively. Technical success was achieved in all patients except one (228/229, 99.6%) in which implantation of a stent to celiac trunk was not possible. There were 4 hospital deaths (1.7%). Neurological complications occurred in 6 patients (2.6%), including 4 (1.7%) spinal cord ischemia and 2 (0.9%) ischemic stroke. There were 1 (0.4%) iatrogenic retrograde dissection and 2 (0.9%) renal failure reported. The mean duration of follow-up was 16.5 months. There were 21 deaths (9.3%) during follow-up and 8 (3.6%) were aorta-related. Thirty three (14.7%) secondary interventions were performed. Five patients (2.2%) required an open completion thoracoabdominal procedure incorporating the stent-graft into the repair. Complete FL thrombosis was observed in 181 (80.4%) patients, 34 (15.1%) had partial thrombosis, and 10 (4.4%) had FL progression. Conclusions: FL embolization of the distal thoracic aorta is a promising technique in a group of patients to promote FL thrombosis and aortic remodeling in thoracic aorta. | - |
dc.language | eng | - |
dc.relation.ispartof | Annals of Vascular Surgery | - |
dc.title | Methods and Outcomes of Endovascular False Lumen Embolization for Thoracic Aortic Dissection | - |
dc.type | Article | - |
dc.description.nature | link_to_subscribed_fulltext | - |
dc.identifier.doi | 10.1016/j.avsg.2022.03.020 | - |
dc.identifier.pmid | 35339592 | - |
dc.identifier.scopus | eid_2-s2.0-85128212947 | - |
dc.identifier.volume | 85 | - |
dc.identifier.spage | 371 | - |
dc.identifier.epage | 382 | - |
dc.identifier.eissn | 1615-5947 | - |
dc.identifier.isi | WOS:000881830700043 | - |