Abstract:
Objective To investigate the clinical effects of thoracic endovascular aortic repair(TEVAR) interventional therapy on patients with acute Stanford type B aortic dissection(TBAD).
Methods A total of 112 TBAD patients admitted to Henan Provincial People' s Hospital from January 2014 to September 2017 were selected. All patients received TEVAR interventional therapy, and they were divided into acute group(disease onset<14 d, 65 cases) and non-acute group(disease onset ≥ 14 d, 47 cases) according to the interventional therapy time. The time from onset to TEVAR treatment, hospital stay, hospitalization cost, postoperative complications and false lumen thrombosis were compared between the two groups. The aortic true lumen/aortic diameter ratio(TLi) and false lumen/aortic diameter ratio(FLi) were observed before and after surgery. Follow-up for 2 years, the survival was analyzed.
Results The time from onset to TEVAR treatment and hospital stay in the acute group were shorter than those in the non-acute group, the hospitalization cost was lower than that in the non-acute group(
t=20.686, 8.090, 3.071,
P<0.05), and the complete absorption rate of false lumen thrombosis was higher than that in the non-acute group(χ
2=5.993,
P<0.05). Three months after surgery, the TLi in the two groups was increased compared with that before surgery, while the FLi was decreased compared with that before surgery, and the improvement in the acute group was higher than that in the non-acute group(
t=5.268, 14.098,
P<0.05). The overall survival rate in the acute group was higher than that in the non-acute group(92.31% vs. 85.11%, Log-rank χ
2=1.479,
P>0.05).
Conclusion TEVAR for patients with acute TBAD has high complete absorption rate of false lumen thrombosis and good postoperative aortic remodeling, and it can shorten hospital stay and reduce hospitalization cost, and it is a better treatment timing.