Cocaine use is associated with worse outcomes in patients treated with thoracic endovascular repair for type B aortic dissection

To describe and compare the clinical and anatomical characteristics and outcomes of patients with and without known cocaine use who underwent thoracic endovascular repair for type B aortic dissections. Between January 2012 and January 2017, 186 patients underwent thoracic endovascular repair for typ...

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Bibliographic Details
Published in:Journal of vascular surgery 2019-07, Vol.70 (1), p.60-66
Main Authors: Yammine, Halim, Krcelic, Daniel, Ballast, Jocelyn K., Briggs, Charles S., Stanley, Gregory, Nussbaum, Tzvi, Frederick, John R., Arko, Frank R.
Format: Article
Language:English
Subjects:
African Americans
Age Factors
Aged
Aneurysm, Dissecting - complications
Aneurysm, Dissecting - diagnostic imaging
Aneurysm, Dissecting - surgery
Aortic Aneurysm, Thoracic - complications
Aortic Aneurysm, Thoracic - diagnostic imaging
Aortic Aneurysm, Thoracic - surgery
Blood Vessel Prosthesis Implantation - adverse effects
Cocaine
Cocaine-Related Disorders - complications
Cocaine-Related Disorders - diagnosis
Dissection
Endoleak - diagnosis
Endoleak - etiology
Endoleak - therapy
Endovascular aortic repair
Endovascular Procedures - adverse effects
Female
Humans
Male
Middle Aged
Retreatment
Retrospective Studies
Risk Assessment
Risk Factors
Smoking - adverse effects
TBAD
TEVAR
Time Factors
Treatment Outcome
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Summary:To describe and compare the clinical and anatomical characteristics and outcomes of patients with and without known cocaine use who underwent thoracic endovascular repair for type B aortic dissections. Between January 2012 and January 2017, 186 patients underwent thoracic endovascular repair for type B aortic dissection at our institution. Clinical data and anatomical characteristics were collected under an institutional review board-approved protocol. Survival, reintervention, complications, and characteristics of dissection were compared between patients with cocaine use (C+; n = 14) and those with no known cocaine use (C−; n = 172). Cocaine users were more likely to be young African American males who smoked. They tended to present with more extensive dissections as evidenced by larger false lumen diameters. They also had higher rates of endoleaks and more reinterventions. These results suggest that special care should be taken to provide close follow-up for these patients.
ISSN:0741-5214
1097-6809
DOI:10.1016/j.jvs.2018.10.061