Key result
Secondary aortic intervention after initial TEVAR for type B aortic dissection did not impair survival compared to primary TEVAR alone.
Why the study?
It was unclear whether patients with type B aortic dissection treated with TEVAR who required secondary aortic intervention had worse survival than those who did not.
Does secondary aortic intervention reduce overall survival in patients treated with TEVAR for type B aortic dissection?
Cohort (n=236)
Yes
Does secondary aortic intervention reduce overall survival in patients treated with TEVAR for type B aortic dissection?
Secondary aortic interventions after initial TEVAR for type B aortic dissection do not significantly impair overall survival, supporting the safety of reintervention when identified during systematic follow-up.
Answers are grounded in this paper and cite their sources.
SAI after TEVAR was not associated with reduced survival; leaves open whether reintervention affects outcomes in type B dissection.
Background and Aims: This study investigated patients with type B aortic dissection (TBAD) who were treated with thoracic endovascular aortic repair (TEVAR). The aim was to study whether patients who needed secondary aortic intervention (SAI) had worse survival than patients who did not require SAI after the initial TEVAR. Methods: Data were collected from the National Care Register for Health Care (CRHC) at the Finnish National Institute for Health and Welfare. All Patients over 15 years of age with TBAD (ICD-10; I71.01) treated with TEVAR during the years 2000–2019 were included in the study. Data were collected retrospectively. A data search of the Official Statistics of Finland Cause of Death registry was carried out to identify the date and cause of death in patients with TBAD. Results: 236 patients with TBAD received TEVAR as primary operative treatment from year 2000 to 2019. SAI after initial TEVAR was performed in 45 (17%) patients during median follow-up time of 5.1 years. There was no significant difference in survival between the patients who underwent primary TEVAR alone and those who required additional SAI ( p = 0.063). Age-adjusted survival did not differ between the groups either. Median follow-up time was significantly longer in the SAI group compared to patients with no SAI (5.9 vs 4.9 years, p = 0.047). The most common cause of death in both groups was an aortic-related event (47%). Conclusions: Based on this study, SAIs may not impair the overall survival of patients previously treated with TEVAR for TBAD. Systematic follow-up after the initial TEVAR may be beneficial in identifying patients with TBAD who may require secondary operation.
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Toimela et al. (2025) conducted a cohort in Type B aortic dissection (TBAD) (n=236). Secondary aortic intervention (SAI) vs. Primary TEVAR alone (no SAI) was evaluated on Survival (p=0.063). Secondary aortic intervention after initial TEVAR for type B aortic dissection did not impair survival compared to primary TEVAR alone.
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