关键词: 无并发症B型主动脉夹层, 主动脉夹层腔内修复手术, 手术时机, 临床特征

Abstract: Objective To provide evidence-based medicine support for clinical decision-making in the acute phase of uncomplicated type B aortic dissection. Methods This study enrolled 598 consecutive patients diagnosed with uncomplicated type B aortic dissection treated with TEVAR from January 2015 to December 2020 at a single center. With a threshold of 48 hours between onset and TEVAR, the patients were termed the Acute-Early group and Acute-Delayed TEVAR group. Descriptive and inferential statistics and Survival Analysis Methods were performed to explore the clinical features between the two groups. Results The mean age was 54.00 （45.25, 61.00） years old and 503 （84.1%） patients were men. The most common symptom was chest pain （86.3%） which is statistically different （92% vs 79.6%, P<0.001） between the two groups. The most common in-hospital complication is the formation of internal leakage in 59（9.9%）. There was no significant difference between the Acute-Early and Acute-Delayed groups in the number of total deaths （20 patients, 6.2% vs 18 patients, 6.5%, P=0.993） and aortic-related events （14 patients, 4.3% vs 7 patients, 2.5%, P=0.336）. The overall 1,3 and 5-year survival rates after TEVAR were 97.5%, 94.7%, and 91.1% respectively, which was also no statistical difference between the two groups. Conclusion The early or delayed TEVAR （threshold of 48 hours between onset and TEVAR） for selected uncomplicated TBADs did not affect the postoperative incidence of hospital complications, aortic-related complications, and ultimate survival. Therefore, patients of this kind can undergo TEVAR either immediately or after a waiting period following the onset of the condition but efforts should be paid to identify the high-risk subgroups of acute uncomplicated TBADs who may benefit from early or delayed TEVAR intervention.

Key words: uncomplicated type B dissection, TEVAR, time, clinical features