Document Type
Article
Publication Date
9-12-2024
Abstract
BACKGROUND: Techniques in endovascular therapy have evolved to offer a promising alternative to medical therapy alone for Type B aortic dissections (TBADs).
AIM: The aim of this meta-analysis was to compare mortality and overall complications between thoracic endovascular aortic repair (TEVAR) and best medical therapy (BMT) in patients with TBADs.
METHODS: We included randomized control trials and prospective or retrospective cohort studies that compared TEVAR and BMT for the treatment of type B aortic dissection. Multiple electronic databases were searched.
RESULTS: Thirty-two cohort studies including 150,836 patients were included. TEVAR was associated with a significantly lower 30-day mortality rate than BMT (RR = 0.79, CI = 0.63, 0.99, P = 0.04), notably in patients ≥ 65 years of age (RR = 0.78, CI = 0.64, 0.95, P = 0.01). The TEVAR group had a significantly prolonged hospital stay (MD = 3.42, CI = 1.69, 5.13, P = 0.0001) and ICU stay (MD = 3.18, CI = 1.48, 4.89, P = 0.0003) compared to the BMT. BMT was associated with increased stroke risk (RR = 1.52, CI = 1.29, 1.79, P < 0.00001). No statistically significant differences in late mortality (1, 3, and 5 years) or intervention-related factors (acute renal failure, spinal cord ischemia, myocardial infarction, respiratory failure, and sepsis) were noted between the groups.
CONCLUSION: Our meta-analysis revealed a significant association between the TEVAR group and a decreased mortality rate of TBAD compared to the medical treatment group, especially in patients aged 65 years or older. Further randomized controlled trials are needed to confirm our findings.
Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.
Recommended Citation
Motawea, Karam; Rouzan, Samah; Elhalag, Rowan; Abdelwahab, Abdelrhaman; Al Hennawi, Hussam; Elshenawy, Salem; Mohamed, Mai Saad; Chébl, Pensée; Madian, Mohamed Salem; Hewalla, Mostafa Elsayed Elsayed; Swed, Sarya; Hafez, Wael; Sawaf, Bisher; Kaspo, Samer; Battikh, Naim; Seijari, Mohammed Najdat; Farwati, Amr; and Rakab, Amine, "Efficacy of Thoracic Endovascular Aortic Repair Versus Medical Therapy for Treatment of Type B Aortic Dissection" (2024). Abington Jefferson Health Papers. Paper 107.
https://jdc.jefferson.edu/abingtonfp/107
PubMed ID
39261808
Language
English
Included in
Cardiovascular Diseases Commons, Health Services Research Commons, Pathological Conditions, Signs and Symptoms Commons, Surgical Procedures, Operative Commons
Comments
This article is the author's final published version in BMC Surgery, Volume 24, Issue 1, 2024, Article number 259.
The published version is available at https://doi.org/10.1186/s12893-024-02555-4.
Copyright © The Author(s) 2024.