Table 4.
The evolution of endovascular management for acute Type III aortic dissection (complicated and uncomplicated)
| Author |
Publication Year |
Sample Size |
Study Length |
Follow up | All cause mortality | Findings / Conclusions | Stent Type |
|---|---|---|---|---|---|---|---|
| Czermak84 | 2000 | 7 | 1996–1999 | Mean: 14 months (1–25 months) | 14.3% | Technical success in 86%; 1 patient dissection into ascending aorta; False lumen thrombosis in 86% |
Talent™1, Vanguard™2 |
| Sailer85 | 2001 | 11 | 1997–2000 | Median: 254 days (2–360 days) | Endoleak in 1 patient; Progressive dissection in 1 patient |
Talent™1 Vanguard™2 Gore EXCLUDER®3 |
|
| Palmer86 | 2002 | 14 | 1999–2001 | Mean: 14 months (1–23 months) | 7.1% | Endoleak in 4 patients | Talent™1, Gore EXCLUDER®3 |
| Palma58 | 2002 | 70 | 1996–2001 | Mean: 29 months (1–55 months) | 8.6% | Success in 93%; 18.9% persistent false lumen; 7.1% conversion surgery |
Custom |
| MacKenzie87 | 2004 | 53 | 1992–2002 | 0.0% | Mortality (30D) surgery 58.3%, first half vs. 7.1%, second half (p = 0.019) |
Talent™1 | |
| Leurs62 | 2004 | 131 | 1997–2003 | 12 months | 6.5% (acute dissection) | 30D mortality: 12% (Emergency), 6.5% (Elective) with 90% (cumulative 1-year survival) and 1.5% (late death) |
Talent™1, Gore EXCLUDER®3 Zenith®4, Endofit™5 |
| Eggebrecht63 (meta-analysis) |
2006 | 248 | 1999–2004 | Mean: 19.5 months | 9.8 % (30 D), 12.6% (1-year) | Success >95%, major complications 14–18%; re-intervention rate 11.9%; rupture during follow up 2.3% |
|
| Won88 | 2006 | 51 | 1994–2003 | Mean: 33 months (12–107 months) |
No procedure related mortality | Type 1 Endoleak 10%; Type 2 Endoleak 3%; 10% with saccular aneurysm; 7% with progressive dilation |
Custom |
| Xu89 | 2006 | 63 | 2001–2005 | Mean: 11.7 months (1–47 months) |
3.2% (30D) | Incomplete seal in 4.8%; 4 patients re-intervention; 98.4% false lumen thrombosis; 89.4% (4 year survival) |
Talent™1, Vasoflow®6 Agis®7, Griking®8 Ankura®9 |
| Schoder90 | 2007 | 28 | 2000–2005 | Mean: 2 years | 10.7% (30D) | 90% treated successfully; 89.3% (3 year survival); 86% false lumen thrombosis |
Talent™1, Gore EXCLUDER®3 |
| Jing91 | 2008 | 42 | 2002–2007 | Mean: 18.7 months | 38.1% | Complications (higher in "earlier term") 21.4%; 90% (5 year survival) |
|
| Chang92 | 2008 | 47 | 2001–2006 | Median: 28.2 months (6–75 months) |
6.1% (30D), 12.8% (acute group) | 9 patients lost to follow-up (death); 30D Endoleak 7.3% |
|
| Parker and Golledge38 (meta-analysis) | 2008 | 942 | 1997–2007 | Mean: 20 months | 9% (in-hospital) | Re-intervention rate 10.4%; Major complications in 8.1%; Rupture 0.8% |
|
| Guangqi93 | 2009 | 72 | 2001–2006 | Mean: 14.4 months | 1.4% (30D) | Successful in 88.9%; Endoleak in 22.4%; 75% (3 year survival); 5 patients lost to follow-up |
Talent™1, Zenith®4 Agis®7, Ankura®9 |
| Kaya94 | 2009 | 37 | 1996–2004 | Mean: 15 months (1–69 months) | 8.0% | Conversion in 2 patients; Intraoperative mortality 1.8% |
Talent™1 |
| Xenos95 (meta-analysis) | 2009 | 13 | 2003–2007 | Mean: 3.4 months (1–10 months) | 7.5% (30D) | Stroke in 15%; stent graft failure in 2 patients; 1 patient died due to endovascular grafting |
Gore TAG®3, Gore EXCLUDER®3 |
| Xiong39 (meta-analysis) |
2009 | 1304 | 2001–2007 | Mean: 27.1 months | 3.1% (30D) | Success rate ≥99% in select cohort; 95.2% (5 year survival); reintervention rate 2.4% |
Custom, Talent™1, Zenith®4 Endofit™5, Vasoflow®6, Agis®7 Griking®8, Ankura®9, Powerlink®10, Aortech®11 |
| Chemelli-Steingruber96 | 2009 | 76 | 1996–2008 | Mean: 41 months (0–97 months) | 23.4% | Freedom from late dissection 83%; rupture free survival 93% |
1
World Medical, Medtronic Vascular Inc., Sunrise, FL
2
Boston Scientific Corp., Natick, MA
3
Thoracic Endoprosthesis, W.L. Gore & Associates, Flagstaff, AZ
4
Cook Inc., Bloomington, IN
5
Endomed Inc., London, United Kingdom
6
Vascore Medical Co. Ltd., Suzhou, China
7
Microport Ltd., Shanghai, China
8
Grikin Ltd., Beijing, China
9
Lifetech Ltd., Shenzen, China
10
Endologix Inc., Irvine, CA
11
Aortech Intl. PLC, London, United Kingdom