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Related Concept Videos

Aneurysm II: Clinical Manifestations and Diagnostic Studies01:21

Aneurysm II: Clinical Manifestations and Diagnostic Studies

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Thoracic, aortic arch and abdominal aneurysms are significant vascular conditions that can present with various clinical manifestations and lead to serious complications. Understanding these manifestations and the appropriate diagnostic studies is essential for effective management and treatment.Thoracic Aortic AneurysmsThoracic aortic aneurysms often remain asymptomatic until they reach a size that impinges on adjacent structures. They typically cause deep, diffuse chest pain that radiates to...
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Aneurysm III: Interprofessional Care01:26

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Aneurysm management involves either conservative medical therapy or surgical intervention, depending on the size and symptoms of the aneurysm. Conservative management is generally reserved for smaller, asymptomatic aneurysms, while larger or symptomatic aneurysms often necessitate surgical repair.Conservative Medical TherapyFor small, asymptomatic aneurysms, particularly abdominal aortic aneurysms (AAA) less than 5.5 centimeters in diameter, conservative medical therapy is recommended. This...
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Aneurysm I: Introduction01:30

Aneurysm I: Introduction

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An aortic aneurysm is a localized outpouching or dilation at a weak point in the artery wall. It may involve different parts of the aorta, such as the abdominal aorta, aortic arch, or thoracic aorta.Etiological factorsSeveral disorders are associated with aortic aneurysms.Congenital causes, such as primary connective tissue disorders like Marfan syndrome, impact the integrity and strength of connective tissues, notably affecting the aorta. Marfan syndrome is a genetic disorder that specifically...
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Aortic Regurgitation III: Medical Management01:25

Aortic Regurgitation III: Medical Management

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Aortic regurgitation (AR) is when the aortic valve does not close or seal properly, leading to backward blood circulation from the aorta into the left ventricle during diastole. Common causes of AR include rheumatic heart disease, congenital valve defects, and aortic root dilation. Managing AR requires a multifaceted approach to alleviate symptoms, preserve left ventricular function, and address the underlying cause of the regurgitation. Patients with symptomatic AR or significant left...
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Aortic Regurgitation II: Clinical Features and Diagnostic Tests01:22

Aortic Regurgitation II: Clinical Features and Diagnostic Tests

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Aortic valve regurgitation (AR) occurs when the aortic valve fails to close properly, allowing blood to flow backward from the aorta into the left ventricle. This backflow can result in two distinct clinical presentations: acute and chronic AR, each characterized by its own set of symptoms and physical findings.Acute Aortic RegurgitationAcute AR presents with a sudden onset of severe symptoms. Patients typically experience profound dyspnea (shortness of breath), chest pain, and signs of left...
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Aortic Regurgitation I: Introduction01:15

Aortic Regurgitation I: Introduction

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IntroductionAortic regurgitation is characterized by the backward flow of blood from the aorta into the left ventricle during diastole and arises from the improper closure of the aortic valve. This condition results in left ventricular volume overload and can stem from both acute and chronic etiologies, each contributing uniquely to the disease's progression and symptomatology.Acute and Chronic CausesAcute aortic regurgitation often results from events that suddenly impair the integrity of the...
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Risk Factor Analysis of Post-TEVAR Distal Aortic Expansion: A Systematic Review and Meta-Analysis.

Dongsheng Cui1,2, Xiang Li1,2, Yonghui Chen2,3

  • 1Department of Vascular Surgery, Tianjin Medical University General Hospital, Tianjin, China.

Journal of Endovascular Therapy : an Official Journal of the International Society of Endovascular Specialists
|March 15, 2026
PubMed
Summary

Distal aortic expansion (DAE) after thoracic endovascular aortic repair (TEVAR) affects 27% of patients. Male sex, myocardial infarction, and peripheral vascular disease increase DAE risk, while thrombosis is protective.

Keywords:
TEVARaortic remodelingdistal aortic enlargementrisk factorstype B aortic dissection

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Area of Science:

  • Vascular Surgery
  • Interventional Cardiology
  • Aortic Disease Management

Background:

  • Distal aortic expansion (DAE) is a critical determinant of long-term outcomes following thoracic endovascular aortic repair (TEVAR).
  • Identifying risk factors for DAE is essential for improving patient management and reducing late complications.

Purpose of the Study:

  • To systematically identify and quantify risk factors associated with postoperative distal aortic expansion (DAE) after TEVAR.
  • To explore predictors of DAE through meta-regression analysis.

Main Methods:

  • Systematic review and meta-analysis of studies from PubMed, Embase, and Cochrane Library databases.
  • Pooled effect estimates calculated using random-effects models; heterogeneity assessed with Cochran's Q and I² statistics.
  • Meta-regression and Egger's test used to explore predictors and publication bias.

Main Results:

  • Twenty-four studies included, reporting a pooled DAE incidence of 27% (95% CI: 21%-35%).
  • Risk factors for DAE included male sex, myocardial infarction, peripheral vascular disease, malperfusion, and postoperative false lumen expansion.
  • Protective factors against DAE were older age, prior cardiac surgery, congestive heart failure, residual dissection, and distal false lumen thrombosis.

Conclusions:

  • DAE after TEVAR is influenced by patient comorbidities and aortic remodeling characteristics.
  • High-risk profiles (male sex, cardiovascular comorbidities, persistent false lumen) can guide optimized surveillance strategies.
  • Findings support risk-adapted surveillance and highlight the importance of false lumen thrombosis for long-term TEVAR durability.