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Outflow through aortic side branches drives false lumen patency in type B aortic dissection

Gerlinde Logghe, Bram Trachet (UGent) , Patrick Segers (UGent) , Julie De Backer (UGent) , Joscha Mulorz, Philip Dueppers, Frank Vermassen (UGent) , Hubert Schelzig, Isabelle Van Herzeele and Markus U. Wagenhäuser
(2021) FRONTIERS IN CARDIOVASCULAR MEDICINE. 8.
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Abstract
Objective: Thoracic endovascular aortic repair (TEVAR) for type B aortic dissection (TBAD) aims to induce false lumen (FL) thrombosis by sealing intimal tears between the true (TL) and the FL, and blocking the inflow into the FL. Incomplete thrombosis of the FL is correlated with poor clinical outcome. We hypothesize that the number of major and minor branches arising from the FL affects FL patency and may negatively influence TEVAR induced FL thrombosis. Methods: Computed tomography (CT)-scans from 89 patients diagnosed with TBAD [best medical treatment (BMT) n = 52, TEVAR n = 37] from two high-volume vascular surgery centers were analyzed retrospectively. Analysis included evaluation of the FL patency status, the number, location and size of intimal tears, and the presence of minor and major side branches originating from the FL. Multiple regression analysis was conducted to evaluate obtained parameters as predictors for FL thrombosis status. Results: In univariate analysis, the strongest correlation for FL patency was found for the number of major (R = 0.79) and minor (R = 0.86) side branches originating from the FL. When applying a multiple linear regression model, the number of major (normalized beta 0.37; P < 0.001) and minor (normalized beta 0.41; P < 0.01) side branches arising from the FL were valid predictors for the axial length of the patent and non-patent FL, and additionally determined the length of the patent FL at 12-month follow-up in patients that underwent TEVAR. Conclusions: Our data suggest that the number of minor side branches that originate from the FL in TBAD is an important determinant of FL patency, to a greater degree than previously assumed.
Keywords
Cardiology and Cardiovascular Medicine, aortic dissection, minor branches, outflow, patency, TEVAR, false lumentrue lumen, INTERNATIONAL REGISTRY, ENDOVASCULAR REPAIR, THROMBOSIS, PREDICTORS, GROWTH, MANAGEMENT, SURVIVAL, INSIGHTS, OUTCOMES, MODELS

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Citation

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MLA
Logghe, Gerlinde, et al. “Outflow through Aortic Side Branches Drives False Lumen Patency in Type B Aortic Dissection.” FRONTIERS IN CARDIOVASCULAR MEDICINE, vol. 8, 2021, doi:10.3389/fcvm.2021.710603.
APA
Logghe, G., Trachet, B., Segers, P., De Backer, J., Mulorz, J., Dueppers, P., … Wagenhäuser, M. U. (2021). Outflow through aortic side branches drives false lumen patency in type B aortic dissection. FRONTIERS IN CARDIOVASCULAR MEDICINE, 8. https://doi.org/10.3389/fcvm.2021.710603
Chicago author-date
Logghe, Gerlinde, Bram Trachet, Patrick Segers, Julie De Backer, Joscha Mulorz, Philip Dueppers, Frank Vermassen, Hubert Schelzig, Isabelle Van Herzeele, and Markus U. Wagenhäuser. 2021. “Outflow through Aortic Side Branches Drives False Lumen Patency in Type B Aortic Dissection.” FRONTIERS IN CARDIOVASCULAR MEDICINE 8. https://doi.org/10.3389/fcvm.2021.710603.
Chicago author-date (all authors)
Logghe, Gerlinde, Bram Trachet, Patrick Segers, Julie De Backer, Joscha Mulorz, Philip Dueppers, Frank Vermassen, Hubert Schelzig, Isabelle Van Herzeele, and Markus U. Wagenhäuser. 2021. “Outflow through Aortic Side Branches Drives False Lumen Patency in Type B Aortic Dissection.” FRONTIERS IN CARDIOVASCULAR MEDICINE 8. doi:10.3389/fcvm.2021.710603.
Vancouver
1.
Logghe G, Trachet B, Segers P, De Backer J, Mulorz J, Dueppers P, et al. Outflow through aortic side branches drives false lumen patency in type B aortic dissection. FRONTIERS IN CARDIOVASCULAR MEDICINE. 2021;8.
IEEE
[1]
G. Logghe et al., “Outflow through aortic side branches drives false lumen patency in type B aortic dissection,” FRONTIERS IN CARDIOVASCULAR MEDICINE, vol. 8, 2021.
@article{8746375,
  abstract     = {{Objective: Thoracic endovascular aortic repair (TEVAR) for type B aortic dissection (TBAD) aims to induce false lumen (FL) thrombosis by sealing intimal tears between the true (TL) and the FL, and blocking the inflow into the FL. Incomplete thrombosis of the FL is correlated with poor clinical outcome. We hypothesize that the number of major and minor branches arising from the FL affects FL patency and may negatively influence TEVAR induced FL thrombosis.

Methods: Computed tomography (CT)-scans from 89 patients diagnosed with TBAD [best medical treatment (BMT) n = 52, TEVAR n = 37] from two high-volume vascular surgery centers were analyzed retrospectively. Analysis included evaluation of the FL patency status, the number, location and size of intimal tears, and the presence of minor and major side branches originating from the FL. Multiple regression analysis was conducted to evaluate obtained parameters as predictors for FL thrombosis status.

Results: In univariate analysis, the strongest correlation for FL patency was found for the number of major (R = 0.79) and minor (R = 0.86) side branches originating from the FL. When applying a multiple linear regression model, the number of major (normalized beta 0.37; P < 0.001) and minor (normalized beta 0.41; P < 0.01) side branches arising from the FL were valid predictors for the axial length of the patent and non-patent FL, and additionally determined the length of the patent FL at 12-month follow-up in patients that underwent TEVAR.

Conclusions: Our data suggest that the number of minor side branches that originate from the FL in TBAD is an important determinant of FL patency, to a greater degree than previously assumed.}},
  articleno    = {{710603}},
  author       = {{Logghe, Gerlinde and Trachet, Bram and Segers, Patrick and De Backer, Julie and Mulorz, Joscha and Dueppers, Philip and Vermassen, Frank and Schelzig, Hubert and Van Herzeele, Isabelle and Wagenhäuser, Markus U.}},
  issn         = {{2297-055X}},
  journal      = {{FRONTIERS IN CARDIOVASCULAR MEDICINE}},
  keywords     = {{Cardiology and Cardiovascular Medicine,aortic dissection,minor branches,outflow,patency,TEVAR,false lumentrue lumen,INTERNATIONAL REGISTRY,ENDOVASCULAR REPAIR,THROMBOSIS,PREDICTORS,GROWTH,MANAGEMENT,SURVIVAL,INSIGHTS,OUTCOMES,MODELS}},
  language     = {{eng}},
  pages        = {{11}},
  title        = {{Outflow through aortic side branches drives false lumen patency in type B aortic dissection}},
  url          = {{http://doi.org/10.3389/fcvm.2021.710603}},
  volume       = {{8}},
  year         = {{2021}},
}
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