{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T18:31:41Z","timestamp":1791916301646,"version":"4.3.4"},"reference-count":16,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"11_suppl_1","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circulation"],"published-print":{"date-parts":[[2009,9,15]]},"abstract":"<jats:p>\n            <jats:bold>\n              <jats:italic>Background\u2014<\/jats:italic>\n            <\/jats:bold>\n            Single-center reports have identified retrograde ascending aortic dissection (rAAD) as a potentially lethal complication of thoracic endovascular aortic repair (TEVAR).\n          <\/jats:p>\n          <jats:p>\n            <jats:bold>\n              <jats:italic>Methods and Results\u2014<\/jats:italic>\n            <\/jats:bold>\n            Between 1995 and 2008, 28 centers participating in the European Registry on Endovascular Aortic Repair Complications reported a total of 63 rAAD cases (incidence, 1.33%; 95% CI, 0.75 to 2.40). Eighty-one percent of patients underwent TEVAR for acute (n=26, 54%) or chronic type B dissection (n=13, 27%). Stent grafts with proximal bare springs were used in majority of patients (83%). Only 7 (15%) patients had intraoperative rAAD, with the remaining occurring during the index hospitalization (n=10, 21%) and during follow-up (n=31, 64%). Presenting symptoms included acute chest pain (n=16, 33%), syncope (n=12, 25%), and sudden death (n=9, 19%) whereas one fourth of patients were asymptomatic (n=12, 25%). Most patients underwent emergency (n=25) or elective (n=5) surgical repair. Outcome was fatal in 20 of 48 patients (42%). Causes of rAAD included the stent graft itself (60%), manipulation of guide wires\/sheaths (15%), and progression of underlying aortic disease (15%).\n          <\/jats:p>\n          <jats:p>\n            <jats:bold>\n              <jats:italic>Conclusions\u2014<\/jats:italic>\n            <\/jats:bold>\n            The incidence of rAAD was low (1.33%) in the present analysis with high mortality (42%). Patients undergoing TEVAR for type B dissection appeared to be most prone for the occurrence of rAAD. This complication occurred not only during the index hospitalization but after discharge up to 1050 days after TEVAR. Importantly, the majority of rAAD cases were associated with the use of proximal bare spring stent grafts with direct evidence of stent graft\u2013induced injury at surgery or necropsy in half of the patients.\n          <\/jats:p>","DOI":"10.1161\/circulationaha.108.835926","type":"journal-article","created":{"date-parts":[[2009,9,14]],"date-time":"2009-09-14T21:55:37Z","timestamp":1252965337000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":276,"title":["Retrograde Ascending Aortic Dissection During or After Thoracic Aortic Stent Graft Placement"],"prefix":"10.1161","volume":"120","author":[{"given":"Holger","family":"Eggebrecht","sequence":"first","affiliation":[{"name":"From the Department of Cardiology (H.E., R.E.), West-German Heart Center Essen, University of Duisburg-Essen, Essen, Germany; the Department of Vascular Surgery (M.T.), St George\u2019s Vascular Institute, St George\u2019s Hospital NHS Trust, London, United Kingdom; the Department of Radiology (H.R.), Centre Hospitalier Universitaire, Hopital de Rangueil, Toulouse, France; the Department of Cardiothoracic Surgery (M.C.), University of Vienna Medical School, Vienna, Austria; the Department of Interventional..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matt","family":"Thompson","sequence":"additional","affiliation":[{"name":"From the Department of Cardiology (H.E., R.E.), West-German Heart Center Essen, University of Duisburg-Essen, Essen, Germany; the Department of Vascular Surgery (M.T.), St George\u2019s Vascular Institute, St George\u2019s Hospital NHS Trust, London, United Kingdom; the Department of Radiology (H.R.), Centre Hospitalier Universitaire, Hopital de Rangueil, Toulouse, France; the Department of Cardiothoracic Surgery (M.C.), University of Vienna Medical School, Vienna, Austria; the Department of Interventional..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Herve\u0301","family":"Rousseau","sequence":"additional","affiliation":[{"name":"From the Department of Cardiology (H.E., R.E.), West-German Heart Center Essen, University of Duisburg-Essen, Essen, Germany; the Department of Vascular Surgery (M.T.), St George\u2019s Vascular Institute, St George\u2019s Hospital NHS Trust, London, United Kingdom; the Department of Radiology (H.R.), Centre Hospitalier Universitaire, Hopital de Rangueil, Toulouse, France; the Department of Cardiothoracic Surgery (M.C.), University of Vienna Medical School, Vienna, Austria; the Department of Interventional..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Czerny","sequence":"additional","affiliation":[{"name":"From the Department of Cardiology (H.E., R.E.), West-German Heart Center Essen, University of Duisburg-Essen, Essen, Germany; the Department of Vascular Surgery (M.T.), St George\u2019s Vascular Institute, St George\u2019s Hospital NHS Trust, London, United Kingdom; the Department of Radiology (H.R.), Centre Hospitalier Universitaire, Hopital de Rangueil, Toulouse, France; the Department of Cardiothoracic Surgery (M.C.), University of Vienna Medical School, Vienna, Austria; the Department of Interventional..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lars","family":"Lo\u0308nn","sequence":"additional","affiliation":[{"name":"From the Department of Cardiology (H.E., R.E.), West-German Heart Center Essen, University of Duisburg-Essen, Essen, Germany; the Department of Vascular Surgery (M.T.), St George\u2019s Vascular Institute, St George\u2019s Hospital NHS Trust, London, United Kingdom; the Department of Radiology (H.R.), Centre Hospitalier Universitaire, Hopital de Rangueil, Toulouse, France; the Department of Cardiothoracic Surgery (M.C.), University of Vienna Medical School, Vienna, Austria; the Department of Interventional..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rajendra H.","family":"Mehta","sequence":"additional","affiliation":[{"name":"From the Department of Cardiology (H.E., R.E.), West-German Heart Center Essen, University of Duisburg-Essen, Essen, Germany; the Department of Vascular Surgery (M.T.), St George\u2019s Vascular Institute, St George\u2019s Hospital NHS Trust, London, United Kingdom; the Department of Radiology (H.R.), Centre Hospitalier Universitaire, Hopital de Rangueil, Toulouse, France; the Department of Cardiothoracic Surgery (M.C.), University of Vienna Medical School, Vienna, Austria; the Department of Interventional..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raimund","family":"Erbel","sequence":"additional","affiliation":[{"name":"From the Department of Cardiology (H.E., R.E.), West-German Heart Center Essen, University of Duisburg-Essen, Essen, Germany; the Department of Vascular Surgery (M.T.), St George\u2019s Vascular Institute, St George\u2019s Hospital NHS Trust, London, United Kingdom; the Department of Radiology (H.R.), Centre Hospitalier Universitaire, Hopital de Rangueil, Toulouse, France; the Department of Cardiothoracic Surgery (M.C.), University of Vienna Medical School, Vienna, Austria; the Department of Interventional..."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_1_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehi493"},{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2006.03.055"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2007.08.020"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1007\/s003920200024"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-2002-32415"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1067\/mva.2002.122884"},{"key":"e_1_3_2_7_2","first-page":"254","volume":"10","year":"2003","unstructured":"Fanelli F, Salvatori FM, Marcelli G, Bezzi M, Totaro M, Vagnarelli S, Dake MD, Rossi P, Passariello R. Type A aortic dissection developing during endovascular repair of an acute type B dissection. J Endovasc Ther. 2003; 10: 254\u2013259.","journal-title":"J Endovasc Ther"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-4975(02)05002-6"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1583\/04-1369.1"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1583\/04-1490MR2.1"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejcts.2008.03.024"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5223(19)34288-6"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1177\/15266028040110S609"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1161\/circ.99.10.1331"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9149(01)02312-8"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2008.06.057"}],"container-title":["Circulation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/CIRCULATIONAHA.108.835926","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T06:23:10Z","timestamp":1715581390000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/CIRCULATIONAHA.108.835926"}},"subtitle":["Insight From the European Registry on Endovascular Aortic Repair Complications"],"short-title":[],"issued":{"date-parts":[[2009,9,15]]},"references-count":16,"journal-issue":{"issue":"11_suppl_1","published-print":{"date-parts":[[2009,9,15]]}},"alternative-id":["10.1161\/CIRCULATIONAHA.108.835926"],"URL":"https:\/\/doi.org\/10.1161\/circulationaha.108.835926","relation":{},"ISSN":["0009-7322","1524-4539"],"issn-type":[{"value":"0009-7322","type":"print"},{"value":"1524-4539","type":"electronic"}],"subject":[],"published":{"date-parts":[[2009,9,15]]},"assertion":[{"value":"2009-09-15","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}