{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T16:01:05Z","timestamp":1791820865007,"version":"4.3.4"},"reference-count":23,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2021,10,25]],"date-time":"2021-10-25T00:00:00Z","timestamp":1635120000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:p><jats:bold>Background:<\/jats:bold> Thoracic endovascular aortic repair (TEVAR) for type B aortic dissection (TBAD) induces false lumen (FL) thrombosis, promotes favorable aortic remodeling, and makes an impact on abdominal aortic branch perfusion patterns. However, little is known about the long-term fate of aortic remodeling and abdominal aortic branch perfusion after TEVAR for TBAD and the effect of FL thrombosis status on these changes.<\/jats:p><jats:p><jats:bold>Materials and methods:<\/jats:bold> Between January 2014 and May 2021, 59 enrolled patients with acute TBAD were treated with TEVAR and had post-operative or follow-up images. Pre-operative, post-operative, and latest follow-up CT angiography (CTA) data were analyzed for the largest diameter of true lumen (TL), FL, and transaorta and for the FL thrombosis status on the stented thoracic aorta, unstented thoracic aorta, and abdominal aorta. Abdominal aorta perfusion patterns were characterized.<\/jats:p><jats:p><jats:bold>Results:<\/jats:bold> The mean follow-up period was 17.1 months. In the stented thoracic aorta, average TL diameters increased, average FL diameters decreased, and average transaortic diameters did not change; 82.6% of the patients had either a stable or shrinking transaortic size and 87% of the patients achieved total FL thrombosis. In the unstented thoracic aorta, average TL diameters increased, transaortic growth and no changes occurred in 39.1 and 45.7% of the patients, respectively, and complete FL thrombosis was present in 50% of the patients. In the abdominal aorta, average FL and transaortic diameters increased, aorta was expanded in 52.2% of the patients, and FL remained patent in 65.2% of the patients. Of the 354 branches, 37 branches (10.5%) exhibited changes in perfusion patterns, 22 branches (6.2%) demonstrated an increased TL perfusion, and 15 branches (4.2%) had an increased FL contribution. Compared with patent or partially thrombosed FL, complete FL thrombosis was accompanied by a bigger decrease in FL diameters, a larger increase in TL diameters, and a higher percentage of abdominal branch TL perfusion.<\/jats:p><jats:p><jats:bold>Conclusions:<\/jats:bold> In majority of the patients, TEVAR stabilized the size of the stented thoracic aorta, namely TL expansion and FL obliteration. However, abdominal aortic FL remained patent FL, and it was expanded with the resultant transaortic growth over a long follow-up period. Abdominal aortic branch perfusion patterns remained largely stable after TEVAR. The failure to achieve FL thrombosis negatively affects the remodeling of a contagious abdominal aortic dissection.<\/jats:p>","DOI":"10.3389\/fcvm.2021.752849","type":"journal-article","created":{"date-parts":[[2021,10,25]],"date-time":"2021-10-25T05:07:30Z","timestamp":1635138450000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":10,"title":["Remodeling of Aortic Configuration and Abdominal Aortic Branch Perfusion After Endovascular Repair of Acute Type B Aortic Dissection: A Computed Tomographic Angiography Follow-Up"],"prefix":"10.3389","volume":"8","author":[{"given":"Zihui","family":"Yuan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yiqing","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bi","family":"Jin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jian","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2021,10,25]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1539","DOI":"10.1056\/NEJM199905203402003","article-title":"Nonsurgical reconstruction of thoracic aortic dissection by stent-graft placement","volume":"340","author":"Nienaber","year":"1999","journal-title":"N Engl J Med"},{"key":"B2","doi-asserted-by":"publisher","first-page":"588","DOI":"10.1016\/j.athoracsur.2013.07.128","article-title":"A systematic review of aortic remodeling after endovascular repair of type B aortic dissection: methods and outcomes","volume":"97","author":"Patterson","year":"2014","journal-title":"Ann Thorac Surg"},{"key":"B3","doi-asserted-by":"publisher","first-page":"407","DOI":"10.1161\/CIRCINTERVENTIONS.113.000463","article-title":"Endovascular repair of type B aortic dissection: long-term results of the randomized investigation of stent grafts in aortic dissection trial","volume":"6","author":"Nienaber","year":"2013","journal-title":"Circ Cardiovasc Interv"},{"key":"B4","doi-asserted-by":"publisher","first-page":"924","DOI":"10.1016\/j.jvs.2017.06.067","article-title":"Aneurysmal degeneration of type B aortic dissections after thoracic endovascular aortic repair: a systematic review","volume":"66","author":"Famularo","year":"2017","journal-title":"J Vasc Surg"},{"key":"B5","doi-asserted-by":"publisher","first-page":"395","DOI":"10.1016\/j.jcin.2008.04.009","article-title":"Complicated acute type B dissection: is surgery still the best option?: a report from the International Registry of Acute Aortic Dissection","volume":"1","author":"Fattori","year":"2008","journal-title":"JACC Cardiovasc Interv"},{"key":"B6","doi-asserted-by":"publisher","first-page":"466","DOI":"10.1583\/08-2643.1","article-title":"Endovascular treatment of acute complicated type B dissection: morphological changes at midterm follow-up","volume":"16","author":"Manning","year":"2009","journal-title":"J Endovasc Ther"},{"key":"B7","doi-asserted-by":"publisher","first-page":"733","DOI":"10.1093\/icvts\/ivy167","article-title":"Comparisons of aortic remodelling and outcomes after endovascular repair of acute and chronic complicated Type B aortic dissections","volume":"27","author":"Chou","year":"2018","journal-title":"Interact Cardiovasc Thorac Surg"},{"key":"B8","doi-asserted-by":"publisher","first-page":"1826","DOI":"10.1016\/j.jvir.2013.08.016","article-title":"Morphologic outcome after endovascular treatment of complicated type B aortic dissection","volume":"24","author":"Eriksson","year":"2013","journal-title":"J Vasc Interv Radiol"},{"key":"B9","first-page":"1118","article-title":"Dissection and dissecting aneurysms of the aorta: twenty-year follow-up of five hundred twenty-seven patients treated surgically","volume":"92","author":"DeBakey","year":"1982","journal-title":"Surgery"},{"key":"B10","doi-asserted-by":"publisher","first-page":"352","DOI":"10.1016\/j.avsg.2020.05.058","article-title":"Effect of thoracic endovascular aortic repair on aortic remodeling in patients with type B aortic dissection in an Asian population","volume":"69","author":"Tang","year":"2020","journal-title":"Ann Vasc Surg"},{"key":"B11","doi-asserted-by":"publisher","first-page":"148","DOI":"10.1016\/j.avsg.2018.05.057","article-title":"Late aortic remodeling after endovascular repair of complicated type B aortic dissection-TEVAR protects only the covered segment of thoracic aorta","volume":"55","author":"Wojciechowski","year":"2019","journal-title":"Ann Vasc Surg"},{"key":"B12","doi-asserted-by":"publisher","first-page":"600","DOI":"10.1016\/j.jvs.2015.03.064","article-title":"Late aortic remodeling persists in the stented segment after endovascular repair of acute complicated type B aortic dissection","volume":"62","author":"Conrad","year":"2015","journal-title":"J Vasc Surg"},{"key":"B13","doi-asserted-by":"publisher","first-page":"1544","DOI":"10.1016\/j.jvs.2013.12.038","article-title":"Aortic remodeling after endovascular treatment of complicated type B aortic dissection with the use of a composite device design","volume":"59","author":"Lombardi","year":"2014","journal-title":"J Vasc Surg"},{"key":"B14","doi-asserted-by":"publisher","first-page":"1878","DOI":"10.1016\/j.athoracsur.2016.09.057","article-title":"Aortic remodeling after endovascular repair of complicated acute type B aortic dissection","volume":"103","author":"Leshnower","year":"2017","journal-title":"Ann Thorac Surg"},{"key":"B15","doi-asserted-by":"publisher","first-page":"349","DOI":"10.1056\/NEJMoa063232","article-title":"Partial thrombosis of the false lumen in patients with acute type B aortic dissection","volume":"357","author":"Tsai","year":"2007","journal-title":"N Engl J Med"},{"key":"B16","doi-asserted-by":"publisher","first-page":"S208","DOI":"10.1016\/j.jtcvs.2012.11.048","article-title":"Importance of false lumen thrombosis in type B aortic dissection prognosis","volume":"145","author":"Trimarchi","year":"2013","journal-title":"J Thorac Cardiovasc Surg"},{"key":"B17","doi-asserted-by":"publisher","first-page":"e003172","DOI":"10.1161\/JAHA.115.003172","article-title":"False lumen status in patients with acute aortic dissection: a systematic review and meta-analysis","volume":"5","author":"Li","year":"2016","journal-title":"J Am Heart Assoc"},{"key":"B18","doi-asserted-by":"publisher","first-page":"977","DOI":"10.1001\/jamasurg.2014.1327","article-title":"Aortic morphologic findings after thoracic endovascular aortic repair for type B aortic dissection","volume":"149","author":"Sigman","year":"2014","journal-title":"JAMA Surg"},{"key":"B19","doi-asserted-by":"publisher","first-page":"255","DOI":"10.3978\/j.issn.2225-319X.2014.05.17","article-title":"Predictors of false lumen thrombosis in type B aortic dissection treated with TEVAR","volume":"3","author":"Tolenaar","year":"2014","journal-title":"Ann Cardiothorac Surg"},{"key":"B20","doi-asserted-by":"publisher","first-page":"11692","DOI":"10.4238\/2015.October.2.2","article-title":"Risk factors associated with aortic remodeling in patients with Stanford type B aortic dissection after thoracic endovascular aortic repair","volume":"14","author":"Wang","year":"2015","journal-title":"Genet Mol Res"},{"key":"B21","doi-asserted-by":"publisher","first-page":"1232","DOI":"10.1016\/j.jvs.2012.04.019","article-title":"Risk factors of incomplete thrombosis in the false lumen after endovascular treatment of extensive acute type B aortic dissection","volume":"56","author":"Qin","year":"2012","journal-title":"J Vasc Surg"},{"key":"B22","doi-asserted-by":"publisher","first-page":"902","DOI":"10.1016\/j.jvs.2016.03.441","article-title":"Remodeling of abdominal aortic branch perfusion after thoracic endovascular aortic repair for aortic dissections","volume":"64","author":"Han","year":"2016","journal-title":"J Vasc Surg"},{"key":"B23","doi-asserted-by":"publisher","first-page":"152","DOI":"10.1016\/j.avsg.2020.06.053","article-title":"Branch Vessel patency after thoracic endovascular aortic repair for type B aortic dissection","volume":"70","author":"Magee","year":"2021","journal-title":"Ann Vasc Surg"}],"container-title":["Frontiers in Cardiovascular Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcvm.2021.752849\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,10,25]],"date-time":"2021-10-25T05:07:33Z","timestamp":1635138453000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcvm.2021.752849\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,10,25]]},"references-count":23,"alternative-id":["10.3389\/fcvm.2021.752849"],"URL":"https:\/\/doi.org\/10.3389\/fcvm.2021.752849","relation":{},"ISSN":["2297-055X"],"issn-type":[{"value":"2297-055X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,10,25]]},"article-number":"752849"}}