Case Control Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Aug 6, 2024; 12(22): 4873-4880
Published online Aug 6, 2024. doi: 10.12998/wjcc.v12.i22.4873
Central nervous injury risk factors after endovascular repair of a thoracic aortic aneurysm with type B aortic dissection
Feng Liang, Jie-Qiong Su
Feng Liang, Department of Vascular Surgery, Qinghai Province Cardiovascular and Cerebrovascular Disease Specialist Hospital, Xining 810012, Qinghai Province, China
Jie-Qiong Su, Department of Neurology, Qinghai Province Cardiovascular and Cerebrovascular Disease Specialist Hospital, Xining 810012, Qinghai Province, China
Author contributions: Liang F performed most of the experiments and wrote the manuscript; Su JQ was responsible for data collection and statistical processing.
Institutional review board statement: The Ethics Committee of the Qinghai Province Cardiovascular and Cerebrovascular Disease Specialist Hospital approved this study.
Informed consent statement: All patients gave informed consent.
Conflict-of-interest statement: No benefits in any form have been received or will be received from any commercial party directly or indirectly related to the subject of this article.
Data sharing statement: The technical appendix, statistical code, and dataset are available from the corresponding author.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: Https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jie-Qiong Su, MBChB, Attending Doctor, Department of Neurology, Qinghai Province Cardiovascular and Cerebrovascular Disease Specialist Hospital, No. 7 Zhuanchang Road, Nanchuan West Road, Chengzhong District, Xining 810012, Qinghai Province, China. jieqiong91@163.com
Received: May 7, 2024
Revised: June 10, 2024
Accepted: June 14, 2024
Published online: August 6, 2024
Processing time: 55 Days and 20.3 Hours
Abstract
BACKGROUND

Aortic dissection is the deadliest disease of the cardiovascular system. Type B aortic dissection accounts for 30%-60% of aortic dissections and is mainly treated by endovascular repair of thoracic endovascular aneurysm repair (TEVAR). However, patients are prone to various complications after surgery, with central nervous system injury being the most common, which seriously affects their prognosis and increases the risk of disability and death. Therefore, exploring the risk factors of central nervous system injury after TEVAR can provide a basis for its prevention and control.

AIM

To investigate the risk factors for central nervous system injury after the repair of a thoracic endovascular aneurysm with type B aortic dissection.

METHODS

We enrolled 306 patients with type B aortic dissection who underwent TEVAR at our hospital between December 2019 and October 2022. The patients were categorized into injury (n = 159) and non-injury (n = 147) groups based on central nervous system injury following surgery. The risk factors for central nervous system injury after TEVAR for type B aortic dissection were screened by comparing the two groups. Multivariate logistic regression analysis was performed.

RESULTS

The Association between age, history of hypertension, blood pH value, surgery, mechanical ventilation, intensive care unit stay, postoperative recovery times on the first day after surgery, and arterial partial pressure of oxygen on the first day after surgery differed substantially (P < 0.05). Multivariate logistic regression analysis indicated that age, surgery time, history of hypertension, duration of mechanical ventilation, and intensive care unit stay were independent risk factors for central nervous system injury after TEVAR of type B aortic dissection (P < 0.05).

CONCLUSION

For high-risk patients with central nervous system injury after TEVAR of type B aortic dissection, early intervention measures should be implemented to lower the risk of neurological discomfort following surgery in high-risk patients with central nervous system injury after TEVAR for type B aortic dissection.

Keywords: Plateau area; Type B aortic dissection; Thoracic endovascular aneurysm repair; Central nervous system injury; Risk factors

Core Tip: This study found that age, surgical time, history of hypertension, duration of mechanical ventilation, and length of intensive care unit stay were independent risk factors for central nervous system injury after thoracic endovascular aneurysm repair. By identifying patients with a higher risk of central nervous system injury after type B coarctation with intrathoracic hemangioma repair early, clinicians can facilitate optimal diagnosis and treatment, thereby reducing the associated mortality and improving the quality of life.