Predictors for thoracic aortic growth in patients with type B aortic dissection after thoracic endovascular aortic repair

被引：1

作者：

Chen, Yonghui ^{[1
,2
,3
]}

Ren, Jianli ^{[1
,4
]}

Liu, Zongwei ^{[1
,2
]}

Cui, Dongsheng ^{[1
,2
]}

Wang, Shuaishuai ^{[1
,2
]}

Bi, Jiaxue ^{[1
,2
]}

Dai, Xiangchen ^{[1
,2
]}

机构：

[1] Tianjin Med Univ, Dept Vasc Surg, Gen Hosp, 154 Anshan Rd, Tianjin 300052, Peoples R China

[2] Tianjin Key Lab Precise Vasc Reconstruct & Organ F, Tianjin, Peoples R China

[3] Zhengzhou Univ, Dept Vasc Surg, Affiliated Hosp 1, Zhengzhou, Peoples R China

[4] Yanan Univ, Dept Cardiovasc Surg, Affiliated Hosp, Yanan, Peoples R China

来源：

VASCULAR | 2024年

基金：

中国国家自然科学基金;

关键词：

Chronic type B aortic dissection; thoracic endovascular aortic repair; residual tear; aortic growth; predictor; FALSE LUMEN; ANEURYSMAL DEGENERATION; MORPHOLOGIC PREDICTORS; TEAR SIZE; SURGERY;

D O I：

10.1177/17085381241273233

中图分类号：

R6 [外科学];

学科分类号：

1002 ; 100210 ;

摘要：

Objective: To identify independent predictors of thoracic aortic growth in patients with type B aortic dissection (TBAD) undergoing thoracic endovascular aortic repair (TEVAR). Methods: A retrospective analysis of the patients undergoing TEVAR for TBAD or intramural hematoma (IMH) from April 2014 to April 2023 was performed. The baseline morphological data of TBAD was established through computed tomography angiography (CTA) before discharge. Patients were divided into two groups based on aortic growth: growth and no growth. Aortic growth defined as an increase >= 5 mm in thoracic maximal aortic diameter during any serial follow-up CTA measurement. Logistic regression following propensity score matching (PSM) was used to identify independent predictors for aortic growth. Receiver operating characteristic curve and cutoff value of independent predictors were calculated. Linear regression was used to establish a correlation between anatomical variables and follow-up aortic diameter. Results: A total of 145 patients with TBAD (n = 122) or IMH (n = 23) undergoing TEVAR were included, with a male of 83.4% and a mean age of 56 +/- 14.1 years. Patients in growth group and no growth group was 26 (17.9%) and 119 (80.1%), respectively. After using PSM method, matched regression analysis showed residual maximal tear diameter (OR = 0.889, 95% CI 0.830-0.952, p = 0.001) and follow-up aortic diameter (OR = 0.977, 95% CI 0.965-0.989, p < 0.001) were independent predictors for aortic growth. The cutoff value was 8.55 mm for residual tear diameter and 40.65 mm for follow-up maximal aortic diameter. The residual maximal tear diameter showed a linear correlation with follow-up aortic diameter (DW = 1.74, R2 = 6.2%, p = 0.033). Conclusions: This study suggested that residual maximal tear diameter >8.55 mm and follow-up aortic diameter >40.65 mm could predict aortic growth in patients with TBAD undergoing TEVAR.

引用

页数：8

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