Aortic Remodeling After Thoracic Endovascular Aortic Repair Of Subacute Standford B Aortic Dissection And Relevant Factors

Objective : To explore the aortic remodeling after thoracic endovascular aortic repair(TEVAR)in subacute Stanford B aortic dissection and analyze relevant factors.Methods:Both the preoperative and postoperative clinical data and imaging materials of50 patients with subacute Stanford B aortic dissection,who had received TEVAR,were retrospectively analyzed.The diameters of the true lumen and false lumen of each segment of aorta were measured within 3 months,6 months and 12 months after TEVAR,and the thrombosis in the thoracic aorta and abdominal aorta were assessed;the results were analyzed.All patients were divided into two groups according to whether the false lumens were disappeared,Relevant factors of aortic remodeling including gender,hypertension,presence of multiple tears and a branch originating from the false lumen were evaluated.Results : Technical success achieved in all patients reaching 100%.During follow-up,there were 8 lost cases.After TEVAR,the true lumen of the thoracic aorta was enlarged while the false lumen of the thoracic aorta became narrowed,the differences were statistically significant(P<0.05)when compared with the preoperative data.After the treatment the diameters of both the true lumen and the false lumen of the abdominal aorta showed no statistically significant changes when compared with the preoperative ones(P>0.05).The false lumen complete thrombosis rate of the thoracic aorta was higher than that of the abdominal aorta;the aortic remodeling effect of the thoracic aorta was good,while the aortic remodeling effect of the aorta below the diaphragmatic angle level was poor.Multivariate analysis showed that: A branch originating from the false lumen(OR=27.45,P<0.05)and the presence of multiple tears(OR=19.02,P<0.05)were determined to be independent risk factors for adverse aortic remodeling after TEVAR in patients with subacute type B aortic dissection.Conclusion : TEVAR of subacute type B aortic dissection can obtain good curative result,and the morphological remodeling effect of the thoracic aorta will be better than that aorta below the diaphragmatic angle level.Branch originating from the false lumen,the presence of multiple tears,hypertension,and endo-leakage affected aortic remodeling.a branch originating from the false lumen and multiple tears were determined to be independent risk factors for adverse aortic remodeling after TEVAR in patients with subacute type B aortic dissection.