Do preoperative partial thrombosis of the false lumen and maximum descending aortic diameter predict late aortic expansion in patients with acute type B aortic dissection treated with TEVAR?
Preoperative partial thrombosis of the false lumen and larger maximum descending aortic diameter strongly predict late aortic expansion in patients undergoing TEVAR for acute type B aortic dissection.
Background: A patent false lumen (FL) in patients with thoracic endovascular aortic repair (TEVAR)-treated type B aortic dissection (TBAD) can cause a significant risk for late aortic expansion (LAE). We hypothesize that preoperative features can predict the occurrence of LAE. Methods: Sufficient preoperative and postoperative follow-up clinical and imaging feature data for patients treated with TEVAR in the First Affiliated Hospital of Nanjing Medical University from January 2018 to December 2020 were collected. A univariate analysis and multivariable logistic regression analysis were used to find potential risk factors of LAE. Results: Ninety-six patients were finally included in this study. The mean age was 54.5 ± 11.7 years and 85 (88.5%) were male. LAE occurred in 15 (15.6%) of 96 patients after TEVAR. Two preoperative factors showed strong associations with LAE according to the multivariable logistic regression analysis: preoperative partial thrombosis of the FL (OR = 10.989 2.295–48.403; p = 0.002) and the maximum descending aortic diameter (OR = 1.385 1.100–1.743 per mm increase; p = 0.006). Conclusions: Preoperative partial thrombosis of the FL and an increase in the maximum aortic diameter are strongly associated with late aortic expansion. Additional interventions of the FL may help to improve the prognosis of patients with the high risk of late aortic expansion.
Dong et al. (Wed,) studied this question.