Regarding 'patient outcomes and thoracic aortic volume and morphologic changes following thoracic endovascular aortic repair in patients with complicated chronic type B aortic dissection'

摘要

We read with great interest the article by Andacheh et al.1 Despite a high perioperative mortality rate, the authors report excellent 1-year results for endovascular treatment of patients with complicated chronic type B dissection. Importantly, the report outlines the degree of aortic remodeling after stent graft treatment in this group of patients, showing expansion of the true lumen and reduction of the false lumen in the thoracic aorta over time. It is, however, not clear from the report if the positive remodeling occurred in all patients or if there was a subgroup with lack of remodeling and continued thoracic aortic expansion requiring reintervention. Interestingly, in patients with aortic dissection extending into the abdominal aorta, the abdominal aorta continued to expand. Although no deaths occurred from rupture during the reported follow-up period of 18 months, this remains a concern in the longer term.