Clinical significance and outcomes of pleural effusion in patients with type B aortic dissection treated by endovascular repair

Abstract

Objective To explore clinical implications of pleural effusion in thoracic endovascular aorta repair (TEVAR) of type B aortic dissection. Methods Clinical data of 28 patients (23 males, 5 females) hospitalized from Jan 2015 to Dec 2016 were analyzed retrospectively.There were ruptured aortic dissection (RAD) (n=7) and the contained aortic dissection (CAD) (n=21) . 26 patients underwent TEVAR, and two patients received conservative treatment. Results 26 patients received TEVAR and operations were successful. 2 patients treated conservatively died. Six patients had bilateral pleural effusion, while 20 had left pleural effusion and two had right pleural effusion. The distribution of pleural effusion was significantly different between CAD and RAD group (χ2=10.4, P<0.05), and the rupture risk was the highest in right sided pleural effusion. The median volume of pleural effusion on right side in RAD group are higher than that in CAD group (Z=-3.293, P=0.001). One patient died of sudden death on post-op 9th day. Pleural effusion disappeared in all 24 patients who were followed-up for more than 3 months.There were no ensuing pleural thickening, pulmonary atelectasis, and lung consolidation. Conclusions Pleural effusion on left side are common in type B aortic dissection, while bulk right pleural effusion may indicate impending rupture . Endovascular therapy is a feasible, safe and effective therapy for aortic dissection with pleural effusion. Key words: Aneurysm, dissecting; Pleural effusion; Endovascular repair