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Risk factors for incomplete thrombosis in false lumen in sub-acute type B aortic dissection post-TEVAR

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Abstract

There is scarce information about the risk factors for incomplete false lumen thrombosis (FLT) among type B aortic dissection (AD) patients, particularly in the sub-acute phase following thoracic endovascular aortic repair (TEVAR). We enrolled consecutive sub-acute type B AD patients at Xinqiao Hospital (Chongqing, China) from May 2010 to December 2019. Patients with severe heart failure, cancer, and myocardial infarction were excluded. The postoperative computed tomography angiography (CTA) data were extracted from the most recent follow-up aortic CTA. Multivariate logistic regressions were applied to identify the association between FLT and clinical or imaging factors. Fifty-five subjects were enrolled in our study. Twelve participants showed complete FLT, and 2 of these died during the follow-up, while 8 patients died in incomplete FLT group. In the multivariate analysis, maximum abdominal aorta diameter (OR 1.20, 95% CI 1.016–1.417 p = 0.032) and the number of branches arising from the false lumen (FL) (OR 15.062, 95% 1.681–134.982 p = 0.015) were significantly associated with incomplete FLT. The C-statistics was 0.873 (95% CI 0.773–0.972) for the model. The FL diameter (p < 0.001) was significantly shorter following TEVAR, while the true lumen diameter (p < 0.001) and maximum abdominal aorta diameter (p = 0.011) were larger after the aortic repair. There were 21.8% of sub-acute type B AD patients presented complete FLT post-TEVAR. Maximum abdominal aorta diameter and the number of branches arising from the FL were independent risk factors for incomplete FLT. The true lumen diameter, maximum abdominal aorta diameter, and FL diameter changed notably following TEVAR.

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Acknowledgements

We would like to thank Lili Yang for her technical assistance in the data search and process.

Funding

This study was supported by the Clinical Scientific Research Project of Army Medical University (CX2019LC113), Clinical Scientific Research Project of Xinqiao Hospital (2018JSLC0018), and 13th Five-Year National Key Research and Development Program (2017AA013).

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Authors and Affiliations

  1. Institute of Cardiovascular Diseases of PLA, PLA, Xinqiao Street, Chongqing, 400038, China

    Zhichun Gao, Zhexue Qin, Dehui Qian, Wenxu Pan, Guiquan Zhou, Zhixia An, Changchun Hou, Luyu Wang, Liying Zhang & Jun Jin

  2. Department of Cardiology, Xinqiao Hospital, Army Medical University (Third Military Medical University), Xinqiao Street, Shapingba District, Chongqing, 400038, China

    Zhichun Gao, Zhexue Qin, Dehui Qian, Wenxu Pan, Guiquan Zhou, Zhixia An, Changchun Hou, Luyu Wang, Liying Zhang & Jun Jin

  3. Department of Radiology, Xinqiao Hospital, Army Medical University (Third Military Medical University), Chongqing, 400038, China

    Tao Gu

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  1. Zhichun Gao
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Gao, Z., Qin, Z., Qian, D. et al. Risk factors for incomplete thrombosis in false lumen in sub-acute type B aortic dissection post-TEVAR. Heart Vessels 37, 505–512 (2022). https://doi.org/10.1007/s00380-021-01926-8

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