Analysis Of Influencing Factors Of Abdominal Aortic Remodeling After TEVAR For Stanford Type B Aortic Dissection

Objective:With the widespread use of Thoracic Endovascular Aortic Repair in Stanford type B aortic dissection,many patients have benefited from this procedure.But its limitations are becoming increasingly apparent.Traditional TEVAR only closed the proximal primary tear while the distal tear remained,leading to the occurrence of long-term complications.This study analyzed the characteristics of abdominal aortic remodeling after TEVAR of Stanford Type B aortic dissection and the influencing factors of abdominal aortic remodeling after TEVAR.To provide reference for future clinical treatment and postoperative management.Methods:Thirty patients with Stanford type B aortic dissection underwent TEVAR in our hospital from January 2016 to January 2020 were retrospectively collected,and their clinical data and preoperative and postoperative whole aortic computed tomography 3D angiography images were collected.Patients were divided into abdominal aortic dilated group and non-dilated group by measuring the diameter changes in the level of celiac trunk,the initial part of left renal artery and the bifurcation of abdominal aorta in preoperative and postoperative CTA（>5mm）.Demographic characteristics such as gender,age and duration of disease were compared between the two groups.The preoperative and postoperative CTA of patients in the two groups were analyzed,and the differences in the number of tears,involving small branch arteries,visceral arteries and large tears in the abdominal aorta belowthe renal artery between the two groups were compared,and the postoperative morphological manifestations of patients in the two groups were analyzed.Results:Among the 30 patients included,15 were in the dilation group and 15 were in the non-dilation group,including 23 males and 7 females.All patients were successfully operated.There were no statistically significant differences between the two groups in gender,age,duration of disease,stage,use of bare stents and coexistings of hypertension,diabetes,cardiovascular disease and renal insufficiency（P>0.05）.The number of patients with celiac trunk involvement in abdominal aortic dilatation group（26.7%）were lower than those in the non-dilatation group（66,7%）（P=0.03）.The number of patients with superior mesenteric artery involvement were significantly lower in the dilated group（6.7%）than in the non-dilated group（33.3%）（P<0.01）,and there was no significant difference in the degree of bilateral renal artery involvement and false lumen thrombosis between the two groups.The number of tears and the number of large distal tears in two groups has significant differences（P