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The provisional extension to induce complete attachment technique is associated with abdominal aortic remodeling and reduces aorta-related adverse events after aortic dissection.

Authors
  • Matsuoka, Tadashi1
  • Hashizume, Kenichi2
  • Honda, Masanori3
  • Harada, Daiki4
  • Ohno, Masatoshi4
  • Ikebata, Koki4
  • Kaneyama, Hiroaki4
  • Takaki, Hidenobu4
  • Lefor, Alan Kawarai5
  • Sasaki, Junichi5
  • Shimizu, Hideyuki6
  • 1 Department of Cardiovascular Surgery, Saiseikai Utsunomiya Hospital, Tochigi, Japan; Department of Emergency and Critical Care Medicine, School of Medicine, Keio University, Tokyo, Japan. , (Japan)
  • 2 Department of Cardiovascular Surgery, Saiseikai Utsunomiya Hospital, Tochigi, Japan. Electronic address: [email protected] , (Japan)
  • 3 Department of Radiology, Saiseikai Utsunomiya Hospital, Tochigi, Japan. , (Japan)
  • 4 Department of Cardiovascular Surgery, Saiseikai Utsunomiya Hospital, Tochigi, Japan. , (Japan)
  • 5 Department of Surgery, Jichi Medical University, Tochigi, Japan. , (Japan)
  • 6 Department of Cardiovascular Surgery, School of Medicine, Keio University, Tokyo, Japan. , (Japan)
Type
Published Article
Journal
Journal of vascular surgery
Publication Date
Jul 01, 2021
Volume
74
Issue
1
Identifiers
DOI: 10.1016/j.jvs.2020.11.038
PMID: 33340702
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

This study evaluated the efficacy of the provisional extension to induce complete attachment (PETTICOAT) technique for type B and postoperative residual type B aortic dissections compared with the conventional thoracic endovascular aortic repair (TEVAR) technique. In this retrospective study, we compared sequential aortic morphologic changes in consecutive patients with type B and postoperative residual type B aortic dissections treated with the PETTICOAT technique between January 2016 and December 2017 with patients treated with the conventional TEVAR between January 2013 and December 2015. Outcomes included aortic remodeling and aorta-related adverse events for 2 years postoperatively. Forty-eight patients were included in this study (24 in the PETTICOAT group, 24 patients in the conventional TEVAR group). Although both groups showed aortic remodeling in the descending thoracic aorta, the PETTICOAT group developed significantly better aortic remodeling in the abdominal aorta compared with the conventional TEVAR group during the observation period. The PETTICOAT group had significantly fewer aorta-related adverse events compared with the conventional TEVAR group (8% vs 54%; P < .001). Aorta-related adverse events more commonly occurred in the poor remodeling group compared with in the good remodeling group (P = .001; hazard ratio, 8.32; 95% confidence interval, 2.26-30.64). This study suggests that the PETTICOAT technique for aortic dissection may promote aortic remodeling and decrease the incidence of aorta-related adverse events. Additional studies are required to confirm these preliminary findings. Copyright © 2020 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.

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