title: Early and midterm results of thoracic endovascular aortic repair of chronic type B aortic dissection.
abstract: OBJECTIVE
  The optimal treatment for chronic type B dissection remains controversial. This study reports early and midterm results of thoracic endovascular aortic repair for chronic type B aortic dissection.
  
  
  METHODS
  From June 2001 to September 2007, a total of 84 patients with chronic type B aortic dissection underwent thoracic endovascular aortic repair. The time between onset of dissection and thoracic endovascular aortic repair was 13.9 +/- 22.0 months (range, 1-120 months). All patients were followed up from 6 to 86 months (mean, 33.2 +/- 19.2 months).
  
  
  RESULTS
  The entry tear was completely sealed in 77 cases (91.7%) during thoracic endovascular aortic repair. The incidence of incomplete seal was 8.3%. The 1-month mortality was 1.2%. One patient had retrograde type A dissection 1 month after the operation. Four patients underwent a second thoracic endovascular aortic repair during follow-up, for endoleak in 3 patients and for newly formed intimal tear in 1 patient. Seven patients (8.3%) died during follow-up. Three died of rupture of the thoracic aorta because of endoleak. The Kaplan-Meier actuarial survival curve showed a 5-year survival of 84.4%. At 5 years, 75.2% of patients were alive with neither endoleak nor reintervention.
  
  
  CONCLUSIONS
  Early and midterm results show that thoracic endovascular aortic repair was effective in the treatment of chronic type B aortic dissection. Endoleak was the main cause of death during follow-up. With increased surgical experience and refinement of the stent graft, results are likely to improve in the future.
authors.affiliation: Division of Cardiac Surgery, Beijing Institute of Heart, Lung & Vascular Diseases, Capital Medical University, Beijing Anzhen Hospital, Beijing 100029, China. xushangdong@vip.sina.com
authors.forename: Shang Dong
authors.initials: SD
authors.lastname: Xu
authors.forename: Fang Jiong
authors.initials: FJ
authors.lastname: Huang
authors.forename: Jin Fei
authors.initials: JF
authors.lastname: Yang
authors.forename: Zhi Zhong
authors.initials: ZZ
authors.lastname: Li
authors.forename: Sheng
authors.initials: S
authors.lastname: Yang
authors.forename: Jia Hui
authors.initials: JH
authors.lastname: Du
authors.forename: Zhao Guang
authors.initials: ZG
authors.lastname: Zhang
mesh_terms: D000328:Adult; D000368:Aged; D001013:Aorta, Thoracic / Q000601:surgery*; D001018:Aortic Diseases / Q000145:classification* / Q000601:surgery*; D002908:Chronic Disease; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000379:methods