Recent evolution in use and effectiveness in mainland China of thoracic endovascular aortic repair of type B aortic dissection

Sci Rep. 2017 Dec 11;7(1):17350. doi: 10.1038/s41598-017-17431-w.

Abstract

A meta-analysis was performed on 175 studies selected among those published in mainland China between 2008 and 2015 on thoracic endovascular aortic repair (TEVAR) for type B aortic dissection (AD). Most TEVAR were performed in Shanghai, Beijing, Hubei and Guangdong in patients with mean age of 53.9 years, and acute (70%) or chronic (30%) type B AD. Procedural success rate was 99.1 ± 0.8%. Major complication rate was 1.7 ± 2.3%, with paraplegia in 0.4 ± 0.0%. Overall in-hospital mortality rate was 1.6 ± 0.9% with AD rupture in 30% (about 40% during first postoperative day); follow-up mortality rate was 2.3 ± 1.1%, with AD rupture in 39.2% (50% within first year). Compared with 2001-2007 data from China, there appeared to be improvement in rates of major complications, paraplegia and in-hospital mortality. Compared with 1999-2004 Western data, rates of procedural success, stroke, and paraplegia appeared similar, while those for major complications, in-hospital mortality, retrograde type A dissection and follow-up mortality appeared lower. Compared with more recent Western data (2006-2013) on acute complicated type B AD, stroke, paraplegia, in-hospital mortality and follow-up mortality appeared lower. Therefore, in mainland China, safety for TEVAR of type B AD appeared better between 2008 and 2015 than in previous periods in China or Western countries.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aortic Aneurysm, Thoracic / surgery*
  • Aortic Dissection / surgery*
  • Endovascular Procedures / methods*
  • Female
  • Humans
  • Male
  • Meta-Analysis as Topic
  • Middle Aged
  • Postoperative Complications*
  • Prognosis