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Endovascular stent graft placement in patients with type B aortic dissection: a meta-analysis in China
Jiang Xiong1, Bo Jiang, Wei Guo
1Department of Vascular Surgery, Clinical Division of Surgery, Chinese PLA General Hospital, Beijing, China. xiongjiangdoc@126.com
Insights
Endovascular stent graft placement for type B aortic dissection in China shows high success rates (99%) with low mortality (2.6% at 30 days). This minimally invasive approach offers favorable outcomes compared to traditional treatments.
Area of Science:
- Cardiovascular Surgery
- Interventional Cardiology
- Vascular Medicine
Background:
- Type B aortic dissection is a life-threatening condition requiring effective treatment strategies.
- Traditional medical management remains a primary approach, but endovascular options are emerging.
Purpose of the Study:
- To summarize the clinical success, complications, and outcomes of endovascular stent graft placement for type B aortic dissection in China.
- To evaluate the safety and efficacy of this procedure based on published Chinese literature.
Main Methods:
- A meta-analysis of 39 studies involving 1304 patients with type B aortic dissection who underwent retrograde endovascular stent graft placement.
- Inclusion criteria required studies to encompass 3 or more patients, with data collected between January 2001 and December 2007.
Main Results:
- Procedural success was achieved in 99.2% of patients.
- Major complications occurred in 3.4%, with neurologic complications in 0.6%. 30-day mortality was 2.6%, and 5-year survival was 95.2%.
- Stroke (0.2%) was more frequent than paraplegia (0%).
Conclusions:
- Endovascular stent graft placement demonstrates significant advantages for type B aortic dissection, achieving high success rates.
- Outcomes in Chinese literature, including survival and complication rates, compare favorably with international data.
- This meta-analysis provides a comprehensive overview of endovascular stent graft placement for type B aortic dissection in China.
Objective:
We summarized all published studies for endovascular stent graft placement among patients with type B aortic dissection in China with respect to clinical success, complications, and outcomes.
Methods:
A meta-analysis was performed on all published studies of retrograde endovascular stent graft placement encompassing 3 or more patients with type B aortic dissection. Thirty-nine studies, involving a total of 1304 patients from January 2001 to December 2007, were included.
Results:
The average patient age was 52 years. Procedural success was reported in 99.2% +/- 0.1% of patients. Major complications were reported in 3.4% +/- 0.1% patients, with the most severe neurologic complications in 0.6%. Periprocedural stroke was encountered more frequently than paraplegia (0.2% vs 0%). The overall 30-day mortality was 2.6% +/- 0.1%. In addition, 1.5% +/- 0.1% of patients died over a mean follow-up period of 27.1 +/- 17.5 months. Life-table analysis yielded overall survival rates of 96.9% at 30 days, 96.7% at 6 months, 96.4% at 1 year, 95.6% at 2 years, and 95.2% at 5 years.
Conclusion:
Although therapy with traditional medicines still remains the first line of treatment for type B aortic dissection, endovascular stent graft placement has shown its advantages, with a success rate of 99% or greater in a select cohort. The technical survival rate, major complications, and acute and midterm survival rates in the Chinese-language literature appeared to favorably compare with that seen in published literature. This analysis is the first to provide an overview of the currently available literature on endovascular stent graft placement in type B aortic dissection in China.
