title: A systematic review of aortic remodeling after endovascular repair of type B aortic dissection: methods and outcomes.
abstract: BACKGROUND
  Endovascular treatments of Stanford type B aortic dissection may help to promote aortic remodeling and reduce the incidence of aortic-related complications. The aim of this study was to review published literature describing aortic remodeling after endovascular treatment of aortic dissection.
  
  
  METHODS
  A systematic review of the literature was performed which was compliant with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The type of aortic morphology measurements made and the methods used to make them were characterized. The endpoints of interest were the change in these measurements over time.
  
  
  RESULTS
  After initial screening, 77 articles were identified; 16 of which met the inclusion criteria. Few studies used three-dimensional reconstruction software and none had validated their measurement protocol. True lumen (TL) and false lumen (FL) diameters, areas, and in some cases volumes were measured. Studies assessed the aorta at a variety of different levels and over different periods of follow-up. Acute dissection patients displayed more consistent degree of remodeling (thoracic FL thrombosis in 80% to 90%) than chronic dissection patients (38% to 91%). Less remodeling was seen below the diaphragm in both groups.
  
  
  CONCLUSIONS
  Aortic remodeling after treatment for dissection is described in a highly heterogeneous manner. Despite this there appears to be a greater degree of complete FL resolution in patients with acute dissection than chronic. Factors such as length of aortic coverage and timing of treatment may explain the variation seen in the chronic dissection group. Consensus-based reporting standards are required to synthesize evidence and inform clinical decisions regarding patient selection and operative timing.
authors.affiliation: St. George's Vascular Institute, London, United Kingdom. Electronic address: matt.thompson@stgeorges.nhs.uk.
authors.forename: Benjamin O
authors.initials: BO
authors.lastname: Patterson
authors.affiliation: St. George's Vascular Institute, London, United Kingdom.
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Cobb
authors.affiliation: St. George's Vascular Institute, London, United Kingdom.
authors.forename: Alan
authors.initials: A
authors.lastname: Karthikesalingam
authors.affiliation: St. George's Vascular Institute, London, United Kingdom.
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Holt
authors.affiliation: St. George's Vascular Institute, London, United Kingdom.
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Hinchliffe
authors.affiliation: St. George's Vascular Institute, London, United Kingdom.
authors.forename: Ian M
authors.initials: IM
authors.lastname: Loftus
authors.affiliation: St. George's Vascular Institute, London, United Kingdom.
authors.forename: Matt M
authors.initials: MM
authors.lastname: Thompson
mesh_terms: D000784:Aortic Dissection / Q000145:classification / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000145:classification / Q000601:surgery*; D057510:Endovascular Procedures / Q000379:methods*; D006801:Humans; D016896:Treatment Outcome
keywords: 26