title: Serial CT volume and thrombus length measurements after endovascular repair of Stanford type B aortic dissection.
abstract: OBJECTIVE
  To evaluate the outcome of stent-graft placement in Stanford type B aortic dissection using contrast-enhanced spiral computed tomographic (CT) measurements of true and false lumen volumes and thrombus length.
  
  
  METHODS
  Among 18 consecutive patients (13 men; mean age 60 years, range 44-79) who underwent endovascular repair of Stanford type B dissection, 12 completed at least a 12-month follow-up, which included CT measurements of true and false lumen volumes and thrombus lengths prior to discharge and at 6 and 12 months postimplantation. Volumes were assessed in 3 different aortic segments (A1, A2, A3) extending from the proximal attachment site of the prosthesis to the aortic bifurcation. In addition, thrombus length was measured to evaluate the influence of clot formation on outcome of the false lumen volume.
  
  
  RESULTS
  Mean follow-up was 27 months (range 12-60). Within 12 months, mean true lumen volumes showed statistically significant increases in the A1 (p<0.001) and A2 (p=0.003) segments; false lumen volumes showed a significant decrease in the A1 segment (p=0.002) but an insignificant increase in the A2 segment. No substantial volume changes were observed in the A3 segment. Extension of clot formation in the false lumen varied among patients and over time. Length of stent-grafts, percentage of stented dissection length, or visceral arteries originating from the false lumen did not significantly influence thrombus development, nor did these parameters or thrombus formation distal to the prosthesis have a relationship to false lumen volumes.
  
  
  CONCLUSIONS
  Volumetric analysis after endovascular repair of Stanford type B dissection shows optimal technical outcome in the stented segment, whereas the false lumen in the segment immediately adjacent to the stent-graft seems to be a vulnerable area. Extension of clot formation beyond the endograft seems to be no reliable predictor of outcome.
authors.affiliation: Department of Radiology, Kurt Amplatz Center, University Hospital of Innsbruck, Austria. benedikt.czermak@uibk.ac.at
authors.forename: Benedikt V
authors.initials: BV
authors.lastname: Czermak
authors.forename: Ammar
authors.initials: A
authors.lastname: Mallouhi
authors.forename: Reinhold
authors.initials: R
authors.lastname: Perkmann
authors.forename: Iris E
authors.initials: IE
authors.lastname: Steingruber
authors.forename: Peter
authors.initials: P
authors.lastname: Waldenberger
authors.forename: Beate
authors.initials: B
authors.lastname: Neuhauser
authors.forename: Gustav
authors.initials: G
authors.lastname: Fraedrich
authors.forename: Tarzis
authors.initials: T
authors.lastname: Jung
authors.forename: Werner R
authors.initials: WR
authors.lastname: Jaschke
mesh_terms: D000328:Adult; D000368:Aged; D000784:Aortic Dissection / Q000601:surgery; D001014:Aortic Aneurysm / Q000000981:diagnostic imaging*; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011856:Radiographic Image Enhancement; D015607:Stents; D013927:Thrombosis / Q000209:etiology; D036542:Tomography, Spiral Computed