Key result
TEVAR plus OMT linked to a 9-point gain in physical quality of life vs OMT alone.
Why the study?
The impact of thoracic endovascular aortic repair on quality of life in patients with uncomplicated type B aortic dissection has not been fully evaluated.
Does thoracic endovascular aortic repair (TEVAR) combined with optimal medical therapy improve quality of life in adult patients with uncomplicated type B aortic dissection compared to optimal medical therapy alone?
Cohort (n=70)
No
Does thoracic endovascular aortic repair (TEVAR) combined with optimal medical therapy improve quality of life in adult patients with uncomplicated type B aortic dissection compared to optimal medical therapy alone?
TEVAR combined with optimal medical therapy significantly improves the physical component of quality of life at 3 years compared to medical therapy alone in patients with uncomplicated type B aortic dissection.
Answers are grounded in this paper and cite their sources.
May support TEVAR for physical QoL in uncomplicated type B dissection; hypothesis-generating and requires RCT confirmation before practice change.
Introduction. Thoracic endovascular aortic repair (TEVAR) is considered a minimally invasive intervention, but the impact of this intervention on quality of life has not yet been fully evaluated. Aim. To analyze patient quality of life and compare outcomes between patients treated with TEVAR in combination with optimal medical therapy versus optimal medical therapy alone. Materials and methods. The retrospective study included adult patients (over 18 years old) who were hospitalized at the State Institution "Heart Institute of the Ministry of Health" between 2018 and 2024 due to dissection of the descending thoracic aorta. Depending on the method of treatment for uncomplicated type B aortic dissection. All patients were divided into two groups: group A – patients who were initially prescribed TEVAR with optimal medical therapy (OMT) and group B – patients who were initially prescribed OMT. Quality of life was assessed using the SF-36 questionnaire. Results. The value of the mental component according to the SF-36 questionnaire at the 3rd year of observation was not significantly different between the study groups (47.0 (39.5; 55.5) points vs. 38 (30.0; 41.0), p=0.093). Patients of group A had significantly higher total values of the physical component of quality of life compared to group B (51.0 (41.5; 54.5) points versus 42.0 (38.0; 47.0) points, p=0.032 ), while patients of group A were characterized by significantly higher values of the parameter "Physical functioning" (59.5; 75.0) points versus 64 (51.0; 68.0) points, p=0.043 and "Pain" (89 ( 71.5;95) points against 77(61.0;91.0) points, p=0.038) in comparison with patients of group B. On the basis of multivariate regression, three independent factors influencing the physical component were established – the presence in the anamnesis of patients with arterial hypertension of the 3rd degree (p=0.021), chronic renal failure (p=0.039) and low adherence to medication (p=0.033) and two independent factors influencing the mental component of quality of life – the presence of arterial hypertension of the 3rd degree in the patient's anamnesis (p=0.011) and the need for intervention on the aorta during the observation period (p=0.021). Conclusions. TEVAR is safe and effective in patients with type B aortic dissection with favorable clinical and quality-of-life outcomes.
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Shkandala et al. (2025) conducted a cohort in Uncomplicated type B aortic dissection (n=70). Thoracic endovascular aortic repair (TEVAR) plus optimal medical therapy vs. Optimal medical therapy alone was evaluated on Physical component of quality of life (SF-36 score) at 3 years (p=0.032). TEVAR combined with optimal medical therapy improved the physical component of quality of life at 3 years compared to optimal medical therapy alone.
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