Aortic-Related Readmission After Thoracic Endovascular Aortic Repair for Type B Aortic Dissection Patients: A Single-Center Retrospective Study

Yuanqing Kan; Lihong Huang; Zhenyu Shi; Daqiao Guo; Yi Si; Weiguo Fu

doi:10.1016/j.avsg.2021.10.072

Aortic-Related Readmission After Thoracic Endovascular Aortic Repair for Type B Aortic Dissection Patients: A Single-Center Retrospective Study

Ann Vasc Surg. 2022 May:82:284-293. doi: 10.1016/j.avsg.2021.10.072. Epub 2021 Dec 10.

Authors

Yuanqing Kan¹, Lihong Huang², Zhenyu Shi¹, Daqiao Guo¹, Yi Si³, Weiguo Fu⁴

Affiliations

¹ Department of Vascular Surgery, National Clinical Research Center for Interventional Medicine, Zhongshan Hospital Fudan University, Shanghai, China.
² Department of Vascular Surgery, National Clinical Research Center for Interventional Medicine, Zhongshan Hospital Fudan University, Shanghai, China; Department of Biostatistics, Zhongshan Hospital Fudan University, Shanghai, China.
³ Department of Vascular Surgery, National Clinical Research Center for Interventional Medicine, Zhongshan Hospital Fudan University, Shanghai, China. Electronic address: si.yi@zs-hospital.sh.cn.
⁴ Department of Vascular Surgery, National Clinical Research Center for Interventional Medicine, Zhongshan Hospital Fudan University, Shanghai, China. Electronic address: fu.weiguo@zs-hospital.sh.cn.

PMID: 34902468
DOI: 10.1016/j.avsg.2021.10.072

Abstract

Objectives: This study aimed to investigate the characteristics of and risk factors for aortic-related readmission after thoracic endovascular aortic repair (TEVAR) for type B aortic dissection (TBAD).

Methods: Data from TBAD patients who underwent TEVAR from 2009-2018 at a Chinese tertiary center were retrospectively collected and analyzed. Enrolled patients were categorized into 2 groups according to whether aortic-related readmission occurred during follow-up, which was defined as hospitalization at least once after the initial procedure due to events that were related to or caused by aortic dissection or the initial procedure.

Results: A total of 1 288 TBAD patients were enrolled, and 99 patients experienced aortic-related readmissions (7.7%), among whom chronic patients had the highest readmission rate (9.8%). The yearly proportion of readmission during the first year after initial procedure revealed a decreasing trend with a -9.7% annual percentage change. Seventy-one patients underwent reintervention (71.7%). Distal aneurysmal degeneration (43.7%) and distal stent graft-induced new entries (32.4%) were 2 major causes for reintervention. Fourteen patients in the reintervention subgroup underwent a second reintervention (19.7%). In-hospital mortality was 1.0% during the readmission and 14.3% during the second readmission. The overall survival was comparable between two groups (P = 0.93).

Conclusions: This study highlighted the importance of surveillance after initial procedure for TBAD patients with potential risk factors for aortic-related readmission, and the predisposition of patients with reintervention to multiple readmissions deserves attention.

Keywords: dissection; endovascular procedures; patient readmission.

MeSH terms

Aortic Aneurysm, Thoracic* / complications
Aortic Aneurysm, Thoracic* / diagnostic imaging
Aortic Aneurysm, Thoracic* / surgery
Aortic Dissection* / complications
Aortic Dissection* / diagnostic imaging
Aortic Dissection* / surgery
Blood Vessel Prosthesis Implantation* / adverse effects
Endovascular Procedures* / adverse effects
Humans
Patient Readmission
Postoperative Complications / etiology
Retrospective Studies
Risk Factors
Time Factors
Treatment Outcome