Fever Management after TEVAR in Patients with Aortic Dissection

Area of Science:

• Cardiovascular Surgery
• Vascular Surgery
• Interventional Cardiology

Background:

• Post-implantation syndrome (PIS) is a noninfectious inflammatory response following thoracic endovascular aortic repair (TEVAR).
• PIS is characterized by fever and elevated inflammatory markers, potentially impacting outcomes in type B aortic dissection (TBAD) patients.
• Understanding PIS risk factors and associations is crucial for optimizing patient care after TEVAR.

Purpose of the Study:

• To analyze risk factors for PIS, major adverse cardiac events (MACE), and overall survival after TEVAR in TBAD patients.
• To investigate the correlation between new-onset mural thrombus and the development of PIS.
• To evaluate postoperative fever management strategies for PIS patients.

Main Methods:

• Retrospective analysis of 90 patients with type B aortic dissection who underwent TEVAR.
• PIS defined by fever (>38°C for >24h) and leucocytosis (>12000/µL), excluding other infectious causes.
• Evaluation of demographic data, operation-related factors, inflammatory markers, and computed tomography (CT) scans for mural thrombus volume.

Main Results:

• 10 out of 50 eligible patients developed PIS.
• Younger patients showed a significantly higher incidence of PIS (p=0.045).
• PIS patients had significantly higher new-onset mural thrombus volume (61 cm³ vs. 12 cm³, p<0.001) and underwent more investigations.

Conclusions:

• Post-implantation syndrome may be associated with an increased rate of new-onset mural thrombus after TEVAR in TBAD.
• No significant difference in overall survival or MACE was observed between PIS and non-PIS groups.
• Further research is needed to establish a definitive link and guide management strategies.