title: Importance of Early Aortic Surveillance after Endovascular Treatment of Type B Aortic Dissection with Malperfusion Syndrome.
abstract: BACKGROUND
  The aim of the study was to assess the incidence and timing of adverse events and complications occurring after endovascular treatment of type B aortic dissection (TBAD) complicated with malperfusion syndrome (MPS).
  
  
  METHODS
  Twenty-eight patients with TBAD and MPS treated endovascularly at our center from January 2006 to January 2015 were evaluated through a retrospective scrutiny of the medical records. The primary end point of the study was aorta-related reintervention. The secondary end point was all-cause mortality.
  
  
  RESULTS
  The MPS included the mesenteric and renal arteries in 14 (50%) and 21 (75%) patients, respectively, the lower extremities in 14 (50%) patients and the spinal cord in 3 (10.7%). The 1-year and 5-year freedom of reintervention rate were 86.2% and 74.7%, respectively. The median time to reintervention was 4.5 months. The main reason for reintervention was type I proximal endoleak which was treated by proximal endograft extensions and appropriate arch-branch management. The perioperative mortality was 14.3% (4 of 28). The mean follow-up was 61.7 months (range, 2-96 months). The short-term and long-term survivals were 82.1% at 1 and 5 years, respectively.
  
  
  CONCLUSIONS
  The results suggest that closer follow-up and imaging surveillance of the aorta are warranted after thoracic endovascular aortic repair treatment of TBAD and MPS. And especially so during the first 6 months to enable timely detection and correction of potential complications.
authors.affiliation: Clinical Research Fellow, Department of Vascular Surgery, St. Franziskus Hospital, Muenster, Germany.
authors.forename: Suteekhanit
authors.initials: S
authors.lastname: Hahtapornsawan
authors.affiliation: Department of Vascular Surgery, St. Franziskus Hospital Muenster, Germany; Clinic of Vascular and Endovascular Surgery, University of Münster, Münster, Germany.
authors.forename: Theodosios
authors.initials: T
authors.lastname: Bisdas
authors.affiliation: Department of Vascular Surgery, St. Franziskus Hospital Muenster, Germany; Clinic of Vascular and Endovascular Surgery, University of Münster, Münster, Germany.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Torsello
authors.affiliation: Department of Vascular Surgery at Union Memorial Hospital, Baltimore, MD.
authors.forename: Frank J
authors.initials: FJ
authors.lastname: Criado
authors.affiliation: Department of Vascular Surgery, St. Franziskus Hospital Muenster, Germany; Clinic of Vascular and Endovascular Surgery, University of Münster, Münster, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Austermann
authors.affiliation: Department of Vascular Surgery, St. Franziskus Hospital Muenster, Germany; Clinic of Vascular and Endovascular Surgery, University of Münster, Münster, Germany. Electronic address: konstantinos.donas@googlemail.com.
authors.forename: Konstantinos P
authors.initials: KP
authors.lastname: Donas
mesh_terms: D000328:Adult; D000368:Aged; D000784:Aortic Dissection / Q000000981:diagnostic imaging* / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D001014:Aortic Aneurysm / Q000000981:diagnostic imaging* / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D001027:Aortography / Q000379:methods*; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000401:mortality; D000072226:Computed Tomography Angiography; D018572:Disease-Free Survival; D042241:Early Diagnosis; D057867:Endoleak / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery; D057510:Endovascular Procedures / Q000009:adverse effects / Q000401:mortality; D005260:Female; D005858:Germany; D006801:Humans; D007511:Ischemia / Q000000981:diagnostic imaging* / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D053208:Kaplan-Meier Estimate; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D011237:Predictive Value of Tests; D012039:Regional Blood Flow; D012086:Reoperation; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome