Objective: To describe the trends in management and outcomes of patients with acute type B aortic dissection in the International Registry of Acute Aortic Dissection. Methods: From 1996 - 2022, 3 908 patients were divided into similar sized quartiles (T1, T2, T3, and T4). In hospital outcomes were analysed for each quartile. Survival rates following admission were compared utilising Kaplan-Meier analyses with Mantel-Cox Log-rank tests. Results: Endovascular treatment increased from 19.1% in T1 to 37.2% in T4 (ptrend < .01). Correspondingly, medical therapy decreased from 65.7% in T1 to 54.0% in T4 (ptrend < .01), and open surgery from 14.8% in T1 to 7.0% in T4 (ptrend < .01). In hospital mortality decreased in the overall cohort from 10.7% in T1 to 6.1% in T4 (ptrend < .01), as well as in medically, endovascularly and surgically treated patients (ptrend = .02, .03, and .01, respectively). Overall post-admission survival at 3 years increased (T1: 74.8% vs. T4: 77.3%; p = .01). Conclusion: Considerable changes in the management of acute type B aortic dissection were observed over time, with a significant increase in the use of endovascular treatment and a corresponding reduction in open surgery and medical management. These changes were associated with a decreased overall in hospital and 3 year post-admission mortality among quartiles.
Trends in Management and Outcomes of Type B Aortic Dissection: A Report From the International Registry of Aortic Dissection / S. Trimarchi, T.G. Gleason, D.R. Brinster, J. Bismuth, E. Bossone, T.M. Sundt, D.G. Montgomery, C. Pai, D. Bissacco, H.W.L. de Beaufort, J.E. Bavaria, F. Mussa, R. Bekeredjian, M. Schermerhorn, D. Pacini, T. Myrmel, M. Ouzounian, A. Korach, E.P. Chen, J.S. Coselli, K.A. Eagle, H.J. Patel. - In: EUROPEAN JOURNAL OF VASCULAR AND ENDOVASCULAR SURGERY. - ISSN 1078-5884. - (2023). [Epub ahead of print] [10.1016/j.ejvs.2023.05.015]
Trends in Management and Outcomes of Type B Aortic Dissection: A Report From the International Registry of Aortic Dissection
S. Trimarchi
Primo
;E. Bossone;D. Bissacco;
2023
Abstract
Objective: To describe the trends in management and outcomes of patients with acute type B aortic dissection in the International Registry of Acute Aortic Dissection. Methods: From 1996 - 2022, 3 908 patients were divided into similar sized quartiles (T1, T2, T3, and T4). In hospital outcomes were analysed for each quartile. Survival rates following admission were compared utilising Kaplan-Meier analyses with Mantel-Cox Log-rank tests. Results: Endovascular treatment increased from 19.1% in T1 to 37.2% in T4 (ptrend < .01). Correspondingly, medical therapy decreased from 65.7% in T1 to 54.0% in T4 (ptrend < .01), and open surgery from 14.8% in T1 to 7.0% in T4 (ptrend < .01). In hospital mortality decreased in the overall cohort from 10.7% in T1 to 6.1% in T4 (ptrend < .01), as well as in medically, endovascularly and surgically treated patients (ptrend = .02, .03, and .01, respectively). Overall post-admission survival at 3 years increased (T1: 74.8% vs. T4: 77.3%; p = .01). Conclusion: Considerable changes in the management of acute type B aortic dissection were observed over time, with a significant increase in the use of endovascular treatment and a corresponding reduction in open surgery and medical management. These changes were associated with a decreased overall in hospital and 3 year post-admission mortality among quartiles.File | Dimensione | Formato | |
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