Meta-analysis Of Mortality Of Standford B Aortic Dissection By Thoracic Endovascular Aortic Repair Versus Optimal Medical Therapy

Object To compare the mortality of Thoracic endovascular aortic repair(TEVAR) with optimal(OMT) medical therapy in type B aortic dissection(TBAD). Methods Running searches in four databases, Pubmed?EMBase?Medline and Cochrane Library,Looking for the mortality of TEVAR and OMT treating TBAD, and then comparing the deference of 30-day mortality,1-year mortality and 5-year mortality between the two sorts of therapy.Using the Revman 5.3 to accomplish the Meta-analysis.Results 8 studies are included after going through all the searching references, involving 2287 patients with TBAD, of which 1023 patients are treated with TEVAR and 1264 patients are treated with OMT. The Meta-analysis indicate that all-cause mortality at 30 days in TEVAR group is higher than that in OMT group, which had significant difference. [OR=2.32,95% CI(1.27,4.23),P=0.006]. But the conclusion may be affected by the selection bias. All-cause mortality at 1 year had no significant difference[OR=1.39,95% CI(0.94,2.06),P=0.10]. All-cause mortality at 5 years had no significant difference [OR=0.95,95% CI(0.54,1.65),P=0.85]. But the conclusion may be not only affected by the selection bias, but also the heterogeneity between the studies. Conclusion According to current data, mortality at 30 days between TEVAR and OMT in TBAD patient exist significant difference, but it is hard to draw to a significant conclusion because of the selection bias.The mortality at 1 year and 5 years between TEVAR and OMT exist no difference. However,more large-scale clinical randomized controlled trials are needed to test conclusion.