Why the study?
It was unclear whether sex differences influence clinical outcomes in patients undergoing thoracic endovascular aortic repair for type B aortic dissection.
Does sex influence clinical outcomes in patients undergoing thoracic endovascular aortic repair for type B aortic dissection?
Does sex influence clinical outcomes in patients undergoing thoracic endovascular aortic repair for type B aortic dissection?
Despite baseline differences, sex does not significantly influence long-term clinical outcomes or survival after TEVAR for type B aortic dissection.
Supports sex-neutral TEVAR decisions for type B dissection; leaves open confirmation in prospective trials.
We aimed to investigate whether sex differences influence the clinical outcomes of patients who undergo thoracic endovascular aortic repair (TEVAR) for type B aortic dissection (TBAD). We retrospectively analyzed a prospectively maintained single-center cohort of patients with TBAD who underwent TEVAR between January 2010 and June 2017. We evaluated the in-hospital and long-term mortality and composite end point. Of the 913 patients, 793 (86.8%) were male and 120 (13.1%) were female. Compared to male patients, the female patients were older, more likely to have diabetes mellitus, but less likely to smoke or have hypertension. The proximal landing zone in 0 and 1 was higher in male patients (P = .023), who were more likely to require an aortic arch bypass. Endoleak, delirium, and ICU stay after stent-graft implantation were also more frequent in men. Sex factor was not associated with in-hospital or long-term mortality or the composite end point in the multivariable regression analyses and Cox regression model. The mean estimated survival time was similar between males and females (2462.9 ± 141.2 vs 2804.1 ± 117.4 days, P = .167) in the propensity score-matched cohort. Despite distinct characteristics between sex, there was no sex-related difference in long-term clinical outcomes after TEVAR for TBAD.
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Luo et al. (2021) studied this question.
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