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Master Thesis

Étude du remodelage de l'aorte dans les dissections aortiques de type B après traitement par endoprothèse thoracique

Abstract : Introduction: Complicated type B aortic dissections are treated with TEVAR which induce aortic remodeling to avoid aneurysmal evolution. Despite this treatment, reoperation is sometimes required to control aortic diameters. How is the evolution of the diameters in the abdominal part? Methods: CT scans of all the patients treated with TEVAR for a type B aortic dissection from 2010 to 2018 in CHU de Caen have been reviewed. Surfaces of the true lumen (TL) and false lumen (FL) have been compared before and after the surgery at the thoracic and abdominal levels. Results: 29 patients have been treated with TEVAR in CHU de Caen from 2010 to 2018. During the follow-up, we observe a significant thoracic remodeling after the surgery with TL expansion (p<0,001) and FL regression (p=0,009). At the coeliac level, we can observe a stability of the TL and a tendency for the FL to increase. This abdominal growth is not significantly more important for the 14 patients who needed a reintervention while 80% of the secondary interventions are for aneurysmal growth. Conclusion: We show a satisfying thoracic remodeling. At the coeliac trunk, we observe a trend in the aortic diameter growth but not significant. This trend is not significative either in the 48% who needed a secondary intervention. The most-at-risk evolution zone is the distal part of the graft on the descending thoracic aorta.
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Master Thesis
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Submitted on : Wednesday, June 9, 2021 - 3:17:22 PM
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Pauline Ruello. Étude du remodelage de l'aorte dans les dissections aortiques de type B après traitement par endoprothèse thoracique. Médecine humaine et pathologie. 2020. ⟨dumas-03255444⟩



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