Analysis Of Risk Factors Of Abdominal Aortic Dilat Ation After TEVAR For Type B Aortic Dissection

Objective:Thoracic Endovascular Aortic Repair has been continuously promoted in the treatment of Type B Aortic Dissection patients,and has achieved satisfactory short-term effects.However,some patients developed late complications such as aneurysmal dilatation after surgery.The purpose of this study was to analyze the risk factors for abdominal aortic dilatation after TEVAR for type B aortic dissection and to reduce the incidence of related complications in patients.Methods:The clinical data of TBAD patients who underwent TEVAR in the Department of Endovascular Surgery of the First Affiliated Hospital of Zhengzhou University from January 2016 to December 2019 were collected.The patients were divided into abdominal aorta dilatation group and non-dilatation group according to the changes of corresponding level aortic diameter(≥5mm or 15%)by three-dimensional computed tomography angiography before and after operation.SPSS 19.0 statistical software was used to analyze the difference of observation indexes between the two groups.Logistic regression analysis was used to analyze the risk factors of abdominal aortic dilatation after TEVAR.Results:A total of 102 patients met the criteria,including 42 patients in the dilation group and 60 patients without dilatation.There was no significant difference in age,sex,body mass index,basic disease,smoking history,drinking history,covered stent length,treatment mode of supraarch branch artery,internal leakage,blood pressure control level,false lumen thrombosis degree and branch artery stent implantation between the two groups.The imaging features of postoperative follow-up showed that there were significant differences in the number of left renal artery involved in false lumen(P<0.036),the number of residual tears(P<0.001),the number of large tears(P<0.001)and the number of small branches of abdominal aorta perfusion(P<0.001)between the two groups.Logistic regression analysis showed that the number of residual lacerations was an independent risk factor for abdominal aortic dilatation after TEVAR(OR,1.508;95%CI,1.246-2.485;P,0.006).Conclusion:Residual tears after TEVAR are a risk factor for abdominal aortic dilatation.Patients with residual tears should be closely followed up to monitor changes in the diameter of the abdominal aorta and actively intervene if necessary.