Clinical Characteristics And Risk Factors Of Post-operative Syndrome In Stanford Type B Aortic Dissection

ObjectiveStudy the clinical characteristics and analyze risk factors for the development of postoperative implantation syndrome after endovascular repair in patients with Stanford type B aortic dissection,In order to clarify the mechanism of post-implantation syndrome and provide an experimental basis for its prevention and treatment.MethodsCase data of 48 patients(preoperatively diagnosed with Stanford type B aortic dissection)who underwent endovascular repair of aortic aneurysm at our hospital from January 2015 to January 2021 were collected.Patients were divided into PIS and non PIS groups according to the diagnostic criteria for post-implantation syndrome,and their clinical changes were summarized retrospectively.Logistic regression analysis was used to identify the high-risk factors and to investigate the association between PIs and the occurrence of postoperative adverse events.Results1.A total of 48 cases were included and divided into the PIS group(n= 18)and non PIS group(n = 30).The incidence of PIS was 37.5% in 42 patients with acute aortic dissection and 6 patients with chronic aortic dissection.There was no significant difference between the two groups in terms of age,gender,body mass index,whether they smoked,previous medical history,whether they had acute onset,duration of hospital stay,duration of surgery,and intraoperative blood loss(p>0.05).2.Postoperative clinical data were compared between the two groups.The results showed that there were significant differences in the levels of C-reactive protein,interleukin-6,procalcitonin,hemoglobin and platelet count(p<0.05).3.Multivariate logistic regression analysis showed that the odds ratio of mural thrombosis,postoperative C-reactive protein level,interleukin-6level,procalcitonin level and hemoglobin level was statistically significant(p<0.05).4.In the two groups,a total of 11 cases had postoperative adverse events,6 cases in PIS group and 5 cases in non PIS group.The main adverse events were cardiovascular events,cerebrovascular events,acute liver and renal insufficiency and death.There was no significant relationship in the incidence of the two groups(p>0.05).5.The two groups were followed up for half a year,the results showed that there was no significant relationship in the incidence of postoperative adverse events(P>0.05).ConclusionsPreoperative mural thrombosis,postoperative C-reactive protein,interleukin-6,procalcitonin increased,hemoglobin decreased are independent risk factors of post implantation syndrome.IL-6 can lead to preoperative mural thrombosis and decrease of hemoglobin,which may play an important role in post implantation syndrome.Preoperative active intervention,prevention of mural thrombosis and postoperative correction of anemia,control of inflammatory reaction can effectively reduce and prevent the occurrence of postoperative adverse events.