Authors
Tsung-Han Cheng, Shao-Wei Chen, Ming-Jer Hsieh, Dong-Yi Chen, Feng-Cheng Chang, Chun-Yu Chen, Ying-Chang Tung, Fu-Chih Hsiao, Pao-Hsien Chu, Yu-Ting Cheng
Published in
Annals of vascular surgery. Oct 28, 2026. Epub Oct 28, 2026.
Abstract
This study assessed thoracic endovascular aortic repair (TEVAR) timing and its impact on outcomes in type B aortic dissection (TBAD).
This multicenter retrospective study included 247 patients who underwent TEVAR for TBAD between 2011 and 2018, using data from the Chang Gung Research Database. Primary outcomes were in-hospital and postdischarge mortality.
The study included 47, 122, and 78 patients with hyperacute (<1 day), acute/subacute (1-90 days), and chronic (>90 days) TBAD, respectively. Chronic TBAD had more aortic expansion before TEVAR (0% vs 6.6% vs 17.6%; P = 0.001). In-hospital mortality was highest in hyperacute TBAD (17%) and lowest in chronic TBAD (6.4%; adjusted P for trend = 0.036); conversely, long-term mortality was highest in chronic TBAD (12.3%) and lowest in hyperacute TBAD (0%; adjusted P for trend = 0.017). A restricted cubic spline model showed that delayed intervention beyond 90 days is associated with increasing long-term mortality risk. Among secondary outcomes, delayed TEVAR was associated with more aortic, cardiovascular, infection-related deaths, and residual aneurysms (adjusted P for trend= 0.039, 0.012, 0.048, and 0.006, respectively).
TEVAR may lead to unfavorable outcomes in hyperacute and chronic TBAD. Delayed TEVAR in chronic TBAD is associated with adverse aortic remodeling and rising long-term mortality. TEVAR before the chronic phase could be considered to improve short- and long-term outcomes.
PMID:
42951200
Bibliographic data and abstract were imported from PubMed on 29 Oct 2026.
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