Branch Vessel Patency After TEVAR for Type B Aortic Dissection

Abstract: Objectives Thoracic endovascular aortic repair (TEVAR) for type B aortic dissections is used to promote false lumen (FL) thrombosis and favorable aortic remodeling, but its impact on occlusion of FL origin branch vessels has not been widely described. We compare FL vs. true lumen (TL) branch vessel patency after TEVAR. Methods Patients treated by TEVAR for type B aortic dissection in zones 2-5 in the Vascular Quality Initiative from 2009-2018 were evaluated. The primary outcome was postoperative branch patency. Secondary outcomes were need for branch vessel intervention, preoperative origin and postoperative patency of individual branch vessels (celiac, SMA, renals, iliacs). A subset analysis was performed comparing acute and chronic dissections Results Of 11,774 patients, 1,484 met criteria for analysis. The left renal was the most common to have false lumen origin (21.6%), while right and left common iliac arteries were the most likely to originate off both lumens (22% and 24%). Branch vessels that originated from the TL, FL, both lumens, or were obstructed had postoperative patency rates of 99%, 99%, 99%, and 87% (p Conclusions Branch vessel patency rates after TEVAR for a type B aortic dissection are high are not significantly different for FL or BL origin vessels compared to TL vessels. Branches that are patent prior to TEVAR almost always remain patent following TEVAR, but branch vessel stenting may be required in