JTCVS structural and endovascular · 2026
Early-term and midterm outcomes of endovascular completion of high-risk subacute and early chronic residual dissection after type A repair.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Ferraresi Marco, Katsarou Maria, Luigi Molinari Alessandro Carlo, Jovanovic Janko, Segreti Sara, Clerici Alberto, Galanti Andrea, Rossi Giovanni
Аннотация
OBJECTIVES: Late mortality, progressive aneurysmal degeneration, and major reinterventions remain frequent after repair of type A aortic dissection. This study aimed to evaluate early- and midterm outcomes of endovascular completion in patients with high-risk residual dissection treated during the subacute or early chronic phase.
METHODS: This study was a single-center retrospective analysis of a prospectively maintained institutional database. All consecutive patients undergoing endovascular completion for high-risk residual aortic dissection after type A dissection repair between January 2017 and September 2025 were included. Completion was performed using thoracic endovascular aortic repair alone or combined with the stented-assisted balloon-induced intimal disruption and relamination technique when distal extension exceeded Ishimaru zone 5. Primary outcomes were 30-day mortality and morbidity, as well as 3- and 5-year survival and reintervention rates.
RESULTS: Among 127 patients surviving initial type A repair, 48 (37.8%) underwent endovascular completion (subacute n = 33; early chronic n = 15). No 30-day deaths occurred, and technical success was achieved in all cases. Major adverse events occurred in 6.2%, with no spinal cord ischemia. Five patients (10.4%) required early reintervention. Median clinical follow-up was 54 months. Estimated survival was 97.9% at 3 years and 90.3% at 5 years. Freedom from major reintervention was 93.5% at 3 years and 89.1% at 5 years. False lumen thrombosis was achieved in 89.6% of thoracic and 81.4% of visceral segments.
CONCLUSIONS: Endovascular completion of high-risk residual dissection after type A repair is safe and effective, providing excellent midterm survival, low major reintervention rates, and high rates of aortic remodeling.
METHODS: This study was a single-center retrospective analysis of a prospectively maintained institutional database. All consecutive patients undergoing endovascular completion for high-risk residual aortic dissection after type A dissection repair between January 2017 and September 2025 were included. Completion was performed using thoracic endovascular aortic repair alone or combined with the stented-assisted balloon-induced intimal disruption and relamination technique when distal extension exceeded Ishimaru zone 5. Primary outcomes were 30-day mortality and morbidity, as well as 3- and 5-year survival and reintervention rates.
RESULTS: Among 127 patients surviving initial type A repair, 48 (37.8%) underwent endovascular completion (subacute n = 33; early chronic n = 15). No 30-day deaths occurred, and technical success was achieved in all cases. Major adverse events occurred in 6.2%, with no spinal cord ischemia. Five patients (10.4%) required early reintervention. Median clinical follow-up was 54 months. Estimated survival was 97.9% at 3 years and 90.3% at 5 years. Freedom from major reintervention was 93.5% at 3 years and 89.1% at 5 years. False lumen thrombosis was achieved in 89.6% of thoracic and 81.4% of visceral segments.
CONCLUSIONS: Endovascular completion of high-risk residual dissection after type A repair is safe and effective, providing excellent midterm survival, low major reintervention rates, and high rates of aortic remodeling.