机构：[1]Departments of Cardiovascular Surgery and Interventional Radiology, Beijing Anzhen Hospital of Capital Medical University and Beijing Institute of Heart, Lung and Blood Vessel Diseases, Bejing, China临床科室医技科室心脏外科中心血管科医学影像科介入诊疗科首都医科大学附属安贞医院
Background. Experience is limited with distal stent graft-induced new entry (SINE) after thoracic endovascular aortic repair (TEVAR) of type B dissection (TBAD). We report the management strategy and outcomes in such patients. Methods. Clinical data were analyzed for 95 patients (age, 53.2 +/- 10.9 years; 82 men) who presented with distal SINE after TEVAR for TBAD. Results. Follow-up was 100% for 7.2 +/- 3 years after primary TEVAR. Distal SINE occurred at a mean of 2.7 +/- 2.4 years. Re-TEVAR was performed for 78, with routine stent grafts in 64 and a more tapered graft in 14. Three patients were managed surgically and 14 medically. Two patients died after re-TEVAR. During follow-up at 5.8 +/- 2.9 years, late death occurred in 19 patients, 7 with medical therapy and 12 with re-TEVAR. Distal SINE recurred in 11 at 3.5 +/- 1.7 years after re-TEVAR. Reintervention significantly improved survival up to 8 years compared with medical therapy (88.3% vs 63.5%, p = 0.001). In 64 patients with routine stent grafts, mortality was 24%, distal SINE recurred in 20%, and recurrence-free survival was 56% at 6 years. Neither death nor recurrence of SINE occurred in 14 patients with a more tapered stent graft. Predictors for distal SINE after primary TEVAR were stent graft length (hazard ratio, 0.984; p = 0.037) and chronic phase (hazard ratio, 1.725; p = 0.049). Conclusions. In TBAD patients with distal SINE after TEVAR, reintervention with re-TEVAR could improve long-term survival significantly. Recurrence of distal SINE was high after re-TEVAR using routine stent grafts. More tapered stent grafts may be helpful in preventing the recurrence of distal SINE. (C) 2019 by The Society of Thoracic Surgeons
基金：
National Science and Technologies Support Program of China [2015BA112B03]; Beijing Major Science and Technology Projects [Z171100001017083]; Beijing Scholar Project
语种：
外文
被引次数：
WOS：
PubmedID：
中科院(CAS)分区：
出版当年[2018]版：
大类|2 区医学
小类|2 区外科3 区心脏和心血管系统3 区呼吸系统
最新[2023]版：
大类|2 区医学
小类|2 区呼吸系统2 区外科3 区心脏和心血管系统
JCR分区：
出版当年[2017]版：
Q1SURGERYQ2CARDIAC & CARDIOVASCULAR SYSTEMSQ2RESPIRATORY SYSTEM
第一作者机构：[1]Departments of Cardiovascular Surgery and Interventional Radiology, Beijing Anzhen Hospital of Capital Medical University and Beijing Institute of Heart, Lung and Blood Vessel Diseases, Bejing, China
共同第一作者：
通讯作者：
通讯机构：[1]Departments of Cardiovascular Surgery and Interventional Radiology, Beijing Anzhen Hospital of Capital Medical University and Beijing Institute of Heart, Lung and Blood Vessel Diseases, Bejing, China[*1]Department of Cardiovascular Surgery, Beijing Anzhen Hospital, Capital Medical University, 2 Anzhen Rd, Beijing 100029, China
推荐引用方式(GB/T 7714)：
Qing Li,Wei-Guo Ma,Jun Zheng,et al.Distal Stent Graft-Induced New Entry After TEVAR of Type B Aortic Dissection: Experience in 15 Years[J].ANNALS OF THORACIC SURGERY.2019,107(3):718-724.doi:10.1016/j.athoracsur.2018.09.043.
APA：
Qing Li,Wei-Guo Ma,Jun Zheng,Shang-Dong Xu,Yu Chen...&Li-Zhong Sun.(2019).Distal Stent Graft-Induced New Entry After TEVAR of Type B Aortic Dissection: Experience in 15 Years.ANNALS OF THORACIC SURGERY,107,(3)
MLA：
Qing Li,et al."Distal Stent Graft-Induced New Entry After TEVAR of Type B Aortic Dissection: Experience in 15 Years".ANNALS OF THORACIC SURGERY 107..3(2019):718-724
医学