Long-term Outcomes of Endovascular Repair of Acute Type B Aortic Dissection: A Systematic Review

Objectives: To assess the long-term efficacy and safety of thoracic endovascular aortic repair (TEVAR) in the treatment of acute type B aortic dissection (ATBAD), emphasizing endpoints such as survival, re-intervention rates and complications throughout prolonged follow-up periods. Methods: An exhaustive search of the four databases yielded 1016 pertinent papers. Following the elimination of duplicates with the Rayyan QCRI and the assessment for relevance, 93 full-text publications were examined, with eight studies eventually satisfying the inclusion requirements. Results: Eight years of study on patients with ATBAD found a long-term mortality rate of 7.7% in uncomplicated cases and 78% in complicated cases, with a total mortality rate of 311 (10%). The post-operative complications and re-intervention rates varied. Preoperative inflammatory and lipid profiles are key predictors of mortality risk. Conclusion: TEVAR, a treatment for ATBAD, has shown potential long-term benefits. However, patient selection should be individualized based on risk factors and anatomical characteristics. Further research is needed to validate these findings, refine clinical guidelines and improve the safety and efficacy of TEVAR in diverse patient populations to ensure optimal treatment outcomes.