The evolution of management of type B aortic dissection in a series of 100 consecutive cases in a tertiary center
| Main Author: | |
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| Publication Date: | 2023 |
| Other Authors: | , , , , , , , , , , , , |
| Format: | Article |
| Language: | eng |
| Source: | Repositórios Científicos de Acesso Aberto de Portugal (RCAAP) |
| Download full: | http://hdl.handle.net/10451/58694 |
Summary: | © 2023 Published by Elsevier Espa˜na, S.L.U. on behalf of Sociedade Portuguesa de Cardiologia. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). |
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The evolution of management of type B aortic dissection in a series of 100 consecutive cases in a tertiary centerAortic dissectionComplicationsDrug therapyEndovascular proceduresPost-dissection aneurysmSurgery© 2023 Published by Elsevier Espa˜na, S.L.U. on behalf of Sociedade Portuguesa de Cardiologia. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).Introduction and objectives: Management of aortic dissection is rapidly evolving. The present study aims to assess paradigm shifts in type B aortic dissection (TBAD) treatment modalities and their outcomes according to clinical presentation and type of treatment. We also aim to assess the impact of endovascular technology in TBAD management in order to define organizational strategies to provide an integrated cardiovascular approach. Methods: We performed a retrospective review with descriptive analysis of the last 100 consecutive patients with TBAD admitted to the Vascular Surgery Department of Centro Hospitalar Universitário Lisboa Norte over a 16-year period. Results were stratified according to treatment modality and stage of the disease. The study was further divided into two time periods, 2003-2010 and 2011-2019, respectively before and after the introduction of a dedicated endovascular program for aortic dissections. Results: A total of 100 patients (83% male; mean age 60 years) were included, of whom 59 were admitted in the acute stage (50.8% with complicated dissections). The other 41 patients were admitted for chronic dissections, most of them for surgical treatment of aneurysmal degeneration. Temporal analysis demonstrated an increase in the number of patients operated for aortic dissection, mainly due to an increase in chronic patients (33.3% in 2003-2010 vs. 64.4% in 2011-2019) and a clear shift toward endovascular treatment from 2015 onward. Overall in-hospital mortality was 14% and was significantly higher in the chronic phase (acute 5.1% vs. chronic 26.8%; OR 5.30, 95% CI 1.71-16.39; p=0.003) and in patients with aneurysmal degeneration, regardless of the temporal phase. Only one death was recorded in the endovascular group. Conclusion: Management of TABD carried an overall mortality of 14% during a 16-year period, but the appropriate use of endovascular technology has substantially reduced in-hospital mortality.ElsevierRepositório da Universidade de LisboaLopes, AlicePedro, Luís MMelo, RyanMoutinho, MarianaSobrinho, GonçaloAmorim, PedroSilvestre, LuísFernandes E Fernandes, RuyMinistro, AugustoMartins, CarlosAlmeida, Ana G.Nobre, AngeloPinto, Fausto J.Fernandes E Fernandes, Jose2023-07-20T13:57:16Z20232023-01-01T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/10451/58694engRev Port Cardiol. 2023 Jul;42(7):603-6120870-255110.1016/j.repc.2022.11.0062174-2030info:eu-repo/semantics/openAccessreponame:Repositórios Científicos de Acesso Aberto de Portugal (RCAAP)instname:FCCN, serviços digitais da FCT – Fundação para a Ciência e a Tecnologiainstacron:RCAAP2025-03-17T14:59:45Zoai:repositorio.ulisboa.pt:10451/58694Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireinfo@rcaap.ptopendoar:https://opendoar.ac.uk/repository/71602025-05-29T03:31:17.034293Repositórios Científicos de Acesso Aberto de Portugal (RCAAP) - FCCN, serviços digitais da FCT – Fundação para a Ciência e a Tecnologiafalse |
| dc.title.none.fl_str_mv |
The evolution of management of type B aortic dissection in a series of 100 consecutive cases in a tertiary center |
| title |
The evolution of management of type B aortic dissection in a series of 100 consecutive cases in a tertiary center |
| spellingShingle |
The evolution of management of type B aortic dissection in a series of 100 consecutive cases in a tertiary center Lopes, Alice Aortic dissection Complications Drug therapy Endovascular procedures Post-dissection aneurysm Surgery |
| title_short |
The evolution of management of type B aortic dissection in a series of 100 consecutive cases in a tertiary center |
| title_full |
The evolution of management of type B aortic dissection in a series of 100 consecutive cases in a tertiary center |
| title_fullStr |
The evolution of management of type B aortic dissection in a series of 100 consecutive cases in a tertiary center |
| title_full_unstemmed |
The evolution of management of type B aortic dissection in a series of 100 consecutive cases in a tertiary center |
| title_sort |
The evolution of management of type B aortic dissection in a series of 100 consecutive cases in a tertiary center |
| author |
Lopes, Alice |
| author_facet |
Lopes, Alice Pedro, Luís M Melo, Ryan Moutinho, Mariana Sobrinho, Gonçalo Amorim, Pedro Silvestre, Luís Fernandes E Fernandes, Ruy Ministro, Augusto Martins, Carlos Almeida, Ana G. Nobre, Angelo Pinto, Fausto J. Fernandes E Fernandes, Jose |
| author_role |
author |
| author2 |
Pedro, Luís M Melo, Ryan Moutinho, Mariana Sobrinho, Gonçalo Amorim, Pedro Silvestre, Luís Fernandes E Fernandes, Ruy Ministro, Augusto Martins, Carlos Almeida, Ana G. Nobre, Angelo Pinto, Fausto J. Fernandes E Fernandes, Jose |
| author2_role |
author author author author author author author author author author author author author |
| dc.contributor.none.fl_str_mv |
Repositório da Universidade de Lisboa |
| dc.contributor.author.fl_str_mv |
Lopes, Alice Pedro, Luís M Melo, Ryan Moutinho, Mariana Sobrinho, Gonçalo Amorim, Pedro Silvestre, Luís Fernandes E Fernandes, Ruy Ministro, Augusto Martins, Carlos Almeida, Ana G. Nobre, Angelo Pinto, Fausto J. Fernandes E Fernandes, Jose |
| dc.subject.por.fl_str_mv |
Aortic dissection Complications Drug therapy Endovascular procedures Post-dissection aneurysm Surgery |
| topic |
Aortic dissection Complications Drug therapy Endovascular procedures Post-dissection aneurysm Surgery |
| description |
© 2023 Published by Elsevier Espa˜na, S.L.U. on behalf of Sociedade Portuguesa de Cardiologia. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). |
| publishDate |
2023 |
| dc.date.none.fl_str_mv |
2023-07-20T13:57:16Z 2023 2023-01-01T00:00:00Z |
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info:eu-repo/semantics/publishedVersion |
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info:eu-repo/semantics/article |
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article |
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publishedVersion |
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http://hdl.handle.net/10451/58694 |
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http://hdl.handle.net/10451/58694 |
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eng |
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eng |
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Rev Port Cardiol. 2023 Jul;42(7):603-612 0870-2551 10.1016/j.repc.2022.11.006 2174-2030 |
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info:eu-repo/semantics/openAccess |
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openAccess |
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application/pdf |
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Elsevier |
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Elsevier |
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