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. 2022 Nov 23:9:1035971.
doi: 10.3389/fcvm.2022.1035971. eCollection 2022.

A retrospective study of thoracic endovascular aortic repair timing in patients with uncomplicated type B dissection who have a smoking history

Hui-Qiang Gao  1 , Guoqi Li  2 , Hong-Kai Zhang  3 , Lan-Lin Zhang  1 , Shang-Dong Xu  1
Affiliations

A retrospective study of thoracic endovascular aortic repair timing in patients with uncomplicated type B dissection who have a smoking history

Hui-Qiang Gao et al. Front Cardiovasc Med. .

Abstract

Objective: To determine the optimal timing of thoracic endovascular aortic repair (TEVAR) for patients with uncomplicated type B dissections who have a smoking history.

Methods: Data from 308 consecutive patients with uncomplicated type B dissections, who have a smoking history and onset-to-TEVAR time within 90 days, were analyzed. The patients were divided into two groups: Acute and subacute phases. Univariate and multivariate regression analyses were performed. Smooth curve fitting and threshold analysis were performed to characterize the relationship between the onset-to-TEVAR time and follow-up deaths.

Results: There were no significant differences between the two groups. Smooth curve fitting and threshold effect analysis showed that if early TEVAR was performed within 9.4 days from onset, there was better long-term survival and there was no significant difference after 9.4 days.

Conclusion: By studying the relationship between onset-to-TEVAR time and all-cause mortality, we found that early TEVAR may have a lower all-cause mortality rate during follow-up in uncomplicated type B dissection patients who have a smoking history and within 90 days from onset.

Keywords: TEVAR; operative time; smoke; thoracic endovascular aortic repair; uncomplicated type B dissection.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
The K-M survival curves of patients with acute and subacute uncomplicated type B dissection who have a history of smoking. The 5-and 10-year survival rates were 95.1% (95% CI: 92.3–98.1%) and 73.1% (95% CI: 60.7–87.9%), respectively. CI, confidence interval.
FIGURE 2
FIGURE 2
The re-intervention curves of patients with acute and subacute uncomplicated type B dissection who have a history of smoking. The 5-and 10-year re-intervention rates were 5.3% (95% CI: 2.6–7.9%) and 7.6% (95% CI: 3.8–11.2%), respectively. CI, confidence interval.
FIGURE 3
FIGURE 3
The spline smoothing plot between onset-to-TEVAR time and follow-up death risk in acute and subacute uncomplicated type B dissection patients who have a history of smoking. The results showed that the curve was elevated in the early stage of the disease, thus the long-term death risk increased with a delay in the onset-to-TEVAR time. When the onset-to-TEVAR time was delayed beyond a specific inflection point (9.4 days), the curve became a near-horizontal state, which indicates that the long-term death risk no longer increased with the delay in onset-to-TEVAR time. RR, Relative risk; TEVAR, thoracic endovascular aortic repair.
See this image and copyright information in PMC

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