Analysis On The Long-term Effect Of TEVAR And The Operation Timing For The Uncomplicated Type B Aortic Dissection Patients

Research objective: 1.Collect the relevant information of applying the TEVAR to the uncomplicated type B aortic dissection patients and analyze the effect of TEVAR on these patients;2.Compare the effects of TEVAR treatment on acute,subacute and chronic uncomplicated type B aortic dissection patients and explore the relationship between the effect of TEVAR and the operation timing.Research methodology: In the first part,we collected the basic and operation information of patients with uncomplicated type B aortic dissection who received the TEVAR treatment during the May of 2001 and the April of 2015,succeeded by follow-up visits.The acquired data were analyzed with an attempt to describe the long-term effect of TEVAR on the uncomplicated type B aortic dissection patients.In the second part,we separated the the uncomplicated type B aortic dissection patients into 3 groups based on their onset time,with one group of acute dissection patients whose onset time was within 14 days,one group of subacute patients whose onset time fell between 15 and 28 days and the last one group of chronic patients whose onset time was longer than 28 days.The serious complications occurring in the operations of the three groups were compared to explore the relationship between the effect of TEVAR and the operation timing for the uncomplicated type B aortic dissection patients.Results: In the first part,through the statistics and follow-up visits,we obtained the information of 851 the uncomplicated type B aortic dissection patients who once received the TEVAR treatment in our hospital.There were 6 deaths in the perioperative period,with a mortality of 0.7%.1 patient(0.1%)was caught by the incomplete paraplegia and 2 patients(0.2%)were caught by the complete paraplegia.The survival rate for patients within 5,10 and 14 years after the operation remained as 96.3%,84.1% and 67.6%.The rate of avoiding the second operations within 5 years and 10 years after the operation was 95.9% and 92.8%.In the second part,there were 452 acute patients,149 subacute patients and 250 chronic patients.5 of the acute patients died in the perioperative period(1.1%)and 4 formed retrograde type A dissection in the follow-up visit period(0.9%).No subacute patients died in the perioperative period and 2 formed the retrograde type A dissection in the follow-up visit period(1.3%).1 of the chronic patients died in the perioperative period and 2 formed the retrograde type A dissection in the follow-up visit period(0.8%).The value P of the death in the acute operation,subacute operation,chronic operation and perioperative periods as well as forming the retrograde type A dissection after the operation are both larger than 0.05,indicating no significant difference.The difference also remains insignificant between the survival curve during the follow-up visit period and the rate of avoiding the second operation among the three groups.Conclusion: 1.The application of TEVAR to the uncomplicated type B aortic dissection patients results in a low mortality,complication rate and a good long-term survival rate.2.There is no significant relation between the operation timing of the uncomplicated type B aortic dissection patients and the perioperative death as well as the formation of the retrograde type A dissection,which does not influence the long-term survival rate and re-operation rate.