Analysis of risk factors for retrograde type A dissection associated with thoracic endovascular aortic repair
10.3760/cma.j.cn112149-20221013-00825
- VernacularTitle:胸主动脉覆膜支架血管腔内修复术相关逆行性A型夹层的危险因素分析
- Author:
Guoquan WANG
1
;
Shuaitao SHI
;
Wenhao HAN
;
Xiaojian LI
;
Qiong WANG
;
Hao NIU
;
Shuiting ZHAI
Author Information
1. 郑州大学人民医院 河南省人民医院 阜外华中心血管病医院血管外科，郑州 450003
- Keywords:
Aortic dissection;
Endovascular aortic repair;
Retrograde type A aortic dissection
- From:
Chinese Journal of Radiology
2023;57(7):784-789
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the risk factors for retrograde type A dissection (RTAD) associated with thoracic endovascular aortic repair (TEVAR) which provided the basis for clinical risk stratification and treatment decision.Methods:The clinical data of 1 688 patients with thoracic aortic disease who underwent TEVAR in our center from January 2004 to December 2019 were retrospectively analyzed. The pathological classification included aortic dissection (1 592 cases) and other thoracic aortic diseases (96 cases). Univariate analysis and categorical multiple logistic regression analysis were used to explore the risk factors for the development of RTAD during or after TEVAR.Results:A total of 18 cases of RTAD were found, with an overall incidence of 1.1% (18/1 688), all of which occurred in aortic dissection group. After adjusting for confounding factors, multivariate logistic regression analysis showed that the incidence of RTAD was significantly decreased(OR=0.27,95%CI 0.07-0.96, P=0.043) when the oversize of stentgraft was 11%-20%, the oversize of stentgraft was ≤10% as the control group, and the difference was statistically significant( P<0.05). The ascending aorta diameter was <40 mm as the control group, and there was no significant difference in the incidence of RTAD between the ≥40 mm group and the control group(OR=2.71,95%CI 0.94-7.84, P=0.065). Conclusions:Aortic dissection is more likely to develop RTAD than other thoracic aortic diseases. A proper stentgraft oversizing ratio could reduce the probability of RTAD. That is to say that a too low stentgraft oversizing ratio is not recommended.
