The characteristics of distal tears affect false lumen thrombosis rate after thoracic endovascular aortic repair for acute type B dissection

被引:5
作者
Li, Da [1 ]
Yuan, Ding [2 ]
Peng, Liqing [3 ]
Zheng, Tinghui [1 ]
Fan, Yubo [4 ]
机构
[1] Sichuan Univ, Dept Appl Mech, 24 South Sect 1, Chengdu 610065, Peoples R China
[2] Sichuan Univ, Dept Vasc Surg, West China Hosp, Chengdu, Peoples R China
[3] Sichuan Univ, West China Hosp, Dept Radiol, Chengdu, Peoples R China
[4] Beihang Univ, Beijing Adv Innovat Ctr Biomed Engn, Sch Biol Sci & Med Engn, Key Lab Biomech & Mechanobiol,Minist Educ, Beijing 100191, Peoples R China
基金
中国国家自然科学基金;
关键词
Distal tears; Aortic dissection; Thrombosis in false lumen; TEVAR; RISK;
D O I
10.1093/icvts/ivab166
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
OBJECTIVES A low false lumen thrombosis rate (FLTR) is common in patients with type B aortic dissection after they have undergone thoracic endovascular aortic repair, which indicates a poor long-term prognosis. This study aimed to establish a quantitative linear regression model to predict false lumen (FL) thrombosis accurately using morphological parameters. METHODS In this retrospective study, we included 59 patients diagnosed with acute type B aortic dissection between 2014 and 2017. Morphological parameters were measured. Univariable and multivariable linear regression analyses were performed, and a linear regression model relating FLTR with the number of re-entry tears was proposed. Ten patients were further chosen to validate the linear relationship, and idealized aortic dissection models were adopted for haemodynamic analysis. RESULTS Only the total area and number of re-entry tears were negatively correlated with FL thrombosis (P<0.001). Moreover, based on the univariable regression, the number of re-entry tears played a more crucial role in FLTR (R-2 = 0.509 vs R-2 = 0.298), and the linear relationship model was created as follows: thrombosis rate (%) = -11.25xdistal tear number + 105.24. This model was perfectly matched in 10 patients (concordance correlation coefficient = 0.880, P=0.947). Moreover, when the total area of re-entry tears was constant, the net blood flow increased rapidly with an increase in the tear count. CONCLUSIONS The number of re-entry tears could be a crucial related factor of FL thrombosis; the larger the number of re-entry tears is, the lower the possibility of thrombosis is.
引用
收藏
页码:755 / 762
页数:8
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