The VIRTUE Registry of type B thoracic dissections--study design and early results

Abstract

Introduction: Endovascular procedures for repair of Type B aortic dissection have become increasingly common and are often considered to be first line therapy for acute complicated dissections. The long term durability of these repairs is largely undefined.

Methods: The Virtue Registry is a prospective, non-randomised, multi centre European Clinical Registry designed to inform on the clinical and morphological outcomes of 100 patients with Type B aortic dissection treated with the Medtronic Valiant thoracic stent graft. Patients with acute, sub-acute and chronic Type B dissections will be prospectively followed for three years. Clinical outcomes and aortic morphology will be defined.

Results: Fifty patients had an acute dissection, 24 a sub-acute dissection and 26 a chronic lesion. The 30-day mortality for the acute, sub-acute and chronic lesions was 8%, 0% and 0%. The in hospital composite outcome (mortality, stroke or paraplegia) for the three groups was 16%, 0% and 3.8% respectively. The effect of left subclavian artery (LSCA) revascularisation was defined with the composite endpoint of patients with a covered, non-revascularised LSCA being 20% as compared to 5.8% in the covered, revascularised group.

Conclusion: The early outcomes for the treatment of Type B aortic dissection are reported in the Virtue Registry. Longer term follow-up is planned to report on clinical and morphological outcomes up to 36 months post-procedure.