340 Type B aortic syndrome: comparison of medical and endovascular management

BackgroundType B aortic syndrome is one of the most life-threatening aortic condition. The management of descending aortic diseases remains controversial. The aim of this study was to compare the results of medical and endovascular treatments of type B aortic syndromes.MethodThe medical records of patients with type B aortic syndrome between 2000 and 2009 were retrospectively revised. Type B aortic syndromes consisted of acute aortic dissection (n= 71), chronic aortic dissection (n=32), aortic hematoma (n=27) or penetrating ulcers (n=4). Patients with traumatic aortic ruptures were excluded. The population was divided into two groups. Patients of group A were medically treated (n=76) and patients of group B underwent endovascular management (n= 58). Short and long term outcomes were compared. The median follow up was 28.5 months.ResultsMean age was 66.3±11.6 years old. The sex ratio was 2.83 (Male/Female).In group B, past history of type A aortic dissection were more frequent (p<.05) and mean aortic diameter of the descending thoracic aorta was higher (p<.0001). There were no other statically significant differences between the two groups. Overall in-hospital mortality was 11.8% in group A and 8.6% in group B (p=0.53). Overall survivals at one year were respectively 84.3% and 88% in group A and B (p=0.54). Overall survivals at five years were respectively 72.4% and 81.1% in group A and B (p=0.2). However a significant difference in mortality appeared at nine years follow up, giving the advantage to the endovascular treatment according to Kaplan-Meier estimates (p