Abstract
Objective
This study aimed to analyze the survival time of patients who underwent thoracic endovascular
aortic replacement (TEVAR) due to acute type 3 aortic dissection and to investigate
comorbid conditions and dissection characteristics that affect survival time.
Materials and Methods
Between 2013 and 2023, 94 patients who underwent TEVAR for type 3 dissection were
retrospectively investigated. Survival time and factors affecting this time (comorbidity
and dissection characteristics) were analyzed.
Results
The most common comorbidities were hypertension (88%). There was no significant difference
between the demographic data of surviving and deceased patients. During the follow-up
period, 57% of the patients survived, and 43% of the patients died. The mean survival
time after TEVAR was 20.1 (0–108) months among patients who died and 47.7 (2–120)
months for patients who lived. The mean number of comorbidities was 2.13 in patients
who died and 2.25 in patients who survived. Survival distribution according to the
type of interventional procedure was 50% for partial closure of the subclavian artery,
38.1% for complete closure, and 66.2% for closure starting from the distal subclavian
artery (p = 0.06). Survival rate was significantly higher in patients who underwent reintervention
(p = 0.005). Mortality was 9.5% in the early period, 25.5% in the first year, 29.7%
in the second year, 34% in the third year, and 39.3% in the first 5 years.
Conclusion
In our study, the survival rate was higher in patients who were followed regularly,
and reintervention was applied when necessary. Therefore, we believe that undetected
or untreated complications after TEVAR, rather than comorbid conditions, negatively
affect survival more.
Keywords TEVAR - PETTICOAT - type 3 dissection - De Bakey type 3 dissection - Stanford type
B dissection
