Comparative Outcome Analysis of N-Butyl Cyanoacrylate Embolization of the False Lumen Versus Thoracic Endovascular Aortic Repair in Aortic Dissection |
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Authors: | Dong Kyu Kim Joon Ho Kwon Heung Kyu Ko Junhyung Lee Kichang Han Gyoung Min Kim Man-Deuk Kim Jong Yun Won Hyun-Chel Joo Young-Guk Ko Do Yun Lee |
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Institution: | 1. Department of Radiology, Severance Hospital, Research Institute of Radiological Science, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Korea;2. Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of UIsan College of Medicine, Seoul, Korea;3. Department of Cardiothoracic Surgery, Cardiovascular Center, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea;4. Division of Cardiology, Department of Internal Medicine, Cardiovascular Center, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea;5. Department of Radiology, Cheonan Chungmu Hospital, Cheonan, Korea |
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Abstract: | PurposeTo evaluate the feasibility, safety, and effectiveness of N-butyl cyanoacrylate (NBCA) embolization for the treatment of aortic dissection.Materials and MethodsIn this single-center retrospective study conducted from February 2003 to June 2019, NBCA embolization of an aortic false lumen was attempted in 12 patients (median age, 59 y; range, 41–68 y) and thoracic endovascular aortic repair (TEVAR) was performed in 53 patients (median age, 59 y; range, 37–70 y) for aortic dissection with one or more indications of persisting pain, malperfusion, rupture or impending rupture, maximal aortic diameter ≥ 55 mm, and/or rapid aortic enlargement. The main exclusion criterion for embolization was the presence of fast blood flow in the aortic false lumen on aortography. The efficacy of NBCA embolization and TEVAR was compared by evaluating technical and clinical outcomes, repeat intervention–free survival (RFS), and overall survival (OS).ResultsTechnical success was achieved in 11 of the 12 patients treated with NBCA embolization (91.7%), and clinical success was achieved in 9 of these 11 (81.8%). No significant difference was found between embolization and TEVAR in clinical success rates (embolization, 81.8%; TEVAR, 84.9%; P = .409) or procedure-related complications (embolization, 1 patient 8.3%]; TEVAR, 4 patients 7.5%]; P = .701). In addition, embolization showed comparable 5-y RFS (embolization, 82.5% ± 9.3; TEVAR, 85.5% ± 4.8; P = .641) and 5-y OS (embolization, 100%; TEVAR, 95.4% ± 3.2; P = .744) rates to TEVAR.ConclusionsNBCA embolization of the false lumen in aortic dissection seems to be a safe and effective treatment modality for the closure of false lumen in selected patients. |
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Keywords: | DTA"} {"#name":"keyword" "$":{"id":"kwrd0015"} "$$":[{"#name":"text" "_":"descending thoracic aorta NBCA"} {"#name":"keyword" "$":{"id":"kwrd0025"} "$$":[{"#name":"text" "$$":[{"#name":"italic" "_":"N"} {"#name":"__text__" "_":"-butyl cyanoacrylate OS"} {"#name":"keyword" "$":{"id":"kwrd0035"} "$$":[{"#name":"text" "_":"overall survival RFS"} {"#name":"keyword" "$":{"id":"kwrd0045"} "$$":[{"#name":"text" "_":"repeat intervention–free survival SINE"} {"#name":"keyword" "$":{"id":"kwrd0055"} "$$":[{"#name":"text" "_":"stent-graft–induced new entry TEVAR"} {"#name":"keyword" "$":{"id":"kwrd0065"} "$$":[{"#name":"text" "_":"thoracic endovascular aortic repair |
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