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NGHIÊN CỨU LÂM SÀNG Issue: Số 105 năm 2023

Early results of thoracic endovascular to treat acute type B intramural hematoma

Phạm Mạnh Hùng: Viện Tim mạch Việt Nam, Bệnh viện Bạch Mai; Dương Công Lĩnh: Bệnh viện Đa khoa Tâm Anh; Nguyễn Thị Thu Hường: Viện Tim mạch Việt Nam, Bệnh viện Bạch Mai; Lê Xuân Thận: Trường Đại học Y Hà Nội; Phạm Minh Tuấn: Trường Đại học Y Hà Nội; Nguyễn Ngọc Quang: Viện Tim mạch Việt Nam, Bệnh viện Bạch Mai;
Published: May 31, 2023
Views: 156
DOI 10.58354/jvc.105.2023.466

Abstract

Background: Intramural hematoma (IMH) is a form of acute aortic syndrome. IMH is a life-threatening condition, with a mortality rate of 21% for type A and 5% for type B. Endovascular is a new minimally invasive method management aortic diseases with many benefits. Thoracic endovascular repair (TEVAR) to treat complicated or high-risk intramural hematoma with promising results.

Purposes: Evaluate the early results of the TEVAR management acute intramural hematoma.

Subjects and methods: This study prospectively analyzed 32 patients admitted Vietnam Heart Institute from January 2018 to the end of June 2021. They were diagnosed with acute type B intramural hematoma and underwent TEVAR . Evaluate the early results after TEVAR to treat acute type B IMH in 1-year follow-up.

Results: Incidence of IMH was higher in males, with 68.8% in man. Hypertension is the most common risk factors for IMH, was present in 84.4% patient with IMH. The technical success rate is 96,88%. The 30-day mortality rate was 0%. The 1-year follow-up mortality rate was 3.12% (caused by pneumonia). The most common complication after TEVAR was the post-implantation syndrome (65.6% in patient with IMH). Acute kidney injury accounted for 12.5%. In -hospital and during longitudinal follow-up stroke event was 3.12%. Results of aortic remodeling refer to increase the total aortic diameter (TAD), decrease in IMH thickness, decrease in ratio total aortic diameter/ true lumen diameter

Conclusion: TEVAR management in patients with acute type B intramural hematoma was safe technique with high success rate that promote remodeling of the aorta.

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Section NGHIÊN CỨU LÂM SÀNG
Issue Số 105 năm 2023