Effectiveness And Safety Of Endovascular Aortic Repair And Open Surgery In Treatment Of Acute Stanford Type B Aortic Dissection

Objective:To systematic evaluate the efficacy and safety of the endovascular aortic repair (endovascular stent placement) and open operation in treatment of acute Stanford type B aortic dissection. Methods:The literatures about clinical controlled trials of endovascular aortic repair and open operation in treatment of acute Stanford type B aortic dissection that were included in CNKI, Wanfang data, VIP, Cochrane Central Register of Controlled Trials of the Cochrane Library, OVID, Pubmed, Medline, EBSCO, EMBASE, Springer Link, Science Direct, and other databases from January1991to January2014were retrieved by computer. RevMan5.1software were used to analyze the clinical trial data. Results:Eight trials (5618patients with acute Stanford B type aortic dissection) were included in the analysis. There was statistically significant difference of the30d mortality after operation between the endovascular repair group and the open operation group, which endovascular repair group was significantly better than the open operation group (OR=0.55,95%CI(0.46-0.65), P<0.00001). In addition, there were significant difference between the occurrence of stroke (OR=0.57,95%CI (0.39～0.84), P=0.005),respiratory failure OR=0.64,95%CI(0.53～0.78), P<0.00001), and cardiac complications (OR=0.49,95%CI(0.38～0.64), P<0.00001), which endovascular repair group was better than the open operation group. However, endovascular repair could not improve the postoperative outcomes of paraplegia (OR=1.30,95%CI (0.82～2.05), P=0.26) and acute renal failure (OR=0.86,95%CI(0.41～1.80), P=0.69). Conclusion: Endovascular repair for treatment acute Stanford type B aortic dissection is preferred method.