Objectives: Inflammation is a hallmark of the initial development and progression of aortic dissection. This study aimed to investigate the value of preoperative inflammatory biomarkers in predicting aorta-related adverse events (AAEs) after thoracic endovascular aortic repair (TEVAR) for type B aortic dissection.
Methods: We included all patients who underwent TEVAR for type B aortic dissection between November 2016 and November 2020 in this single-center, retrospective cohort study. Patients were divided into two groups: the AAEs group (n = 75) and the non-AAEs group (n = 126). Preoperative inflammatory biomarkers were recorded, including neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), platelet-to-lymphocyte ratio (PLR), systemic immune inflammation index (SII), and systemic inflammatory response index (SIRI). Patients were followed-up for the development of AAEs. Prediction accuracy of inflammatory biomarkers for AAEs were evaluated using the area under the receiver operating characteristic curves.
Results: This study included 201 patients, of whom 80.0% were men, with a mean age of 59.1 ± 12.5 years. A total of 75 patients developed AAEs after TEVAR. The AUCs of NLR, MLR, PLR, SII, and SIRI for AAEs were.746,.782,.534,.625 and.807, respectively. Age and SIRI were independent risk factors for the AAEs after TEVAR (HR 3.264, p <.001; HR 4.281, p <.001, respectively). Survival analysis revealed significantly lower AAE-free status in patients with preoperative SIRI > = 4 (p <.001).
Conclusion: Increased preoperative SIRI and age are independent risk factors for AAEs after TEVAR in type B aortic dissection.
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http://dx.doi.org/10.3389/fimmu.2022.992463 | DOI Listing |
We present the case of a 74-year-old female patient with a 50 mm ascending aortic aneurysm who underwent ascending aorta replacement. During routine open heart surgery, suboptimal flow in the cardiopulmonary bypass circuit, led to the discovery of a type B aortic dissection with substantial flow in the false lumen. Conservative management was chosen, focusing on blood pressure control in the ICU.
View Article and Find Full Text PDFJ Thorac Cardiovasc Surg
January 2025
Department of Surgery, Division of Vascular Surgery, University of Maryland School of Medicine.
Objective: We present our experience with endovascular Bentall procedure (Endo-Bentall) using a modular valve conduit (Endo-Bentall) in high-risk patients with aortic root pathologies.
Methods: The physician constructed Endo-Bentall device is composed of a self-expanding transcatheter aortic valve (TAVR), aortic endovascular stent graft (TEVAR), and two wire-reinforced fenestrations for coronary artery stenting. The TAVR valve is sutured into an appropriately sized TEVAR graft.
J Thorac Cardiovasc Surg
January 2025
University of Maryland School of Medicine, Division of Cardiothoracic Surgery. Electronic address:
Objective: Over 30% of patients presenting with acute type A aortic dissection (ATAAD) are considered high - risk or inoperable. This study aims to investigate the early and mid-term outcomes of complex endovascular aortic repair of aortic root, ascending aorta, and aortic arch among patients with ATAAD.
Methods: From January 2018 to January 2023, 29 patients who were considered high risk for open operation underwent endovascular aortic repair.
A 65-year-old patient was admitted to the Institute with complaints of shortness of breath, palpitation, and limb edema. Comorbidities were type 2 diabetes mellitus, gout, obesity. Echo: left ventricular ejection fraction 22%, left ventricular aneurysm (LVA), floating thrombus 5.
View Article and Find Full Text PDFCardiovasc Intervent Radiol
January 2025
Department of Surgery, Rijnstate Hospital, Arnhem, The Netherlands.
Purpose: To investigate the influence of antithrombotic therapy on occurrence of thrombotic and bleeding complications after endovascular aneurysm repair (EVAR).
Methods: In this retrospective single-center cohort study, patients who underwent elective endovascular aneurysm repair for abdominal aortic aneurysm were categorized into three antithrombotic groups: single antiplatelet therapy (SAPT), anticoagulants, or dual antiplatelet therapy (DAPT). Outcome measures were the incidence of major adverse cardiovascular events (MACE), prosthetic limb occlusions, and bleeding complications during follow-up.
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