Comparison of mid-term outcomes of endovascular repair and medical management in patients with acute uncomplicated type B aortic dissection

ObjectivesTo further assess the early and mid-term outcomes of thoracic endovascular aortic repair (TEVAR) in patients with acute uncomplicated type B dissection (TBAD) compared those receiving best medical treatment (BMT).MethodsBetween February 2008 March 2018, 357 consecutive TBAD were retrospectively analyzed. Among them, 191 underwent TEVAR, 166 received BMT. After propensity score matching, we obtained 145 matched pairs for analysis.ResultsIn population, 30-day mortality between TEVAR group BMT showed no statistically significant difference, whereas adverse events rates significantly greater than that (P = .003). Freedom from all-cause was (TEVAR: 91.9% at 5 years, BMT: 82.2% P .028). aortic-related 94.1% 86.1% .044). Multivariable Cox-hazard regression analysis demonstrated older age (hazard ratio [HR], 1.04; 95% confidence interval [CI], 1.01-1.08, .013), (HR, 2.33; CI, 1.08-5.05, .032), distance primary entry tear left subclavian artery <2.0 cm 2.30; 1.06-4.99, .035) risk factors death. Given death as a competing factor, cumulative incidence rupture (BMT: 13.7% TEVAR: 5.1% .024).ConclusionsDespite more complications stage, associated decreased late had fewer ruptures TBAD. Therefore, may be considered first option to improve these patients.