Relationship between the number of residual tears in visceral artery segment and vascular remodeling after endovascular repair of thoracic aorta
10.3760/cma.j.cn112434-20240511-00130
- VernacularTitle:胸主动脉腔内修复术后内脏动脉段残余裂口数量与血管重塑的关系
- Author:
Xiaotong WANG
1
;
Liang CHEN
1
;
Yong YAO
1
Author Information
1. 黔西南州人民医院心脏血管外科，贵州兴义 562400
- Publication Type:Journal Article
- Keywords:
Thoracic endovascular aortic repair;
Number of residual tears in the visceral artery segment;
Vascular remodeling
- From:
Chinese Journal of Thoracic and Cardiovascular Surgery
2025;41(3):168-176
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the relationship between the number of residual tears in visceral artery segment and vascular remodeling after thoracic aortic endovascular repair (TEVAR).Methods:A total of 100 patients diagnosed with complicated Stanford type B aortic dissection (cTBAD) and treated with TEVAR in our hospital from June 2018 to June 2023 were collected retrospectively as study objects, and were divided into benign remodeling group (58 cases) and non-benign remodeling group (42 cases) according to prognosis. The clinical data, imaging indexes before and after operation, and early postoperative morphological characteristics were compared between the two groups. The independent influencing factors of internal artery remodeling after operation were analyzed by multivariate logistic analysis. Cox proportional risk regression was used to analyze the association between the number of residual tears in visceral artery segments and non-benign remodeling at different disease stages. The relationship between the number of residual tears and non-benign remodeling of visceral artery segments was analyzed by the restricted cubic spline method combined with spline function and logistic regression. Results:Compared with the benign remodeling group, the age and disease stage of the non-benign remodeling group were significantly increased ( P<0.05). After operation, the diameter and area of celiac trunk (CAT), superior mesenteric artery (SMA), left renal artery (LRA) and right renal artery (RRA) were significantly increased ( P<0.05), while the diameter and area of CAT, SMA and LRA were significantly decreased ( P<0.05). The maximum diameter of the lumen, the number of residual lacerations in the visceral artery segment and the number of lumen originating from the lumbar artery were significantly increased ( P<0.05). Further logistic regression analysis showed that age, disease stage, plane true lumen area and plane thrombus area of CAT and SMA, plane true lumen area of LRA and RRA, and number of residual tears of visceral artery segment were independent factors influencing the remodeling of internal arteries after surgery. Cox proportional risk regression analysis showed that the number of residual visceral artery segments was significantly correlated with non-benign remodeling under different disease stages. The multiplicative interaction terms of the number of residual visceral artery segments and disease stages were 0.028 and 0.031 in people aged ≤58.7 years old and>58.7 years old, respectively. Restricted cubic spline analysis showed that regardless of age and disease stage, there was a nonlinear dose-response relationship between the number of residual tears in visceral artery segment and the intensity of non-benign remodeling association, and the number of residual tears in visceral artery segment ≥2 significantly increased the risk of non-benign remodeling. Conclusion:The number of residual tears in visceral artery segment was significantly correlated with vascular remodeling after TEVAR, and the correlation strength with non-benign remodeling showed a nonlinear dose-response relationship. When the number of residual tears in visceral artery segment was ≥2, the risk of non-benign remodeling was significantly increased.
