In this retrospective study, patients with TBAD and CHD who underwent EVAR shows favorable safety on antiplatelet therapy.
In the present study, we evaluated the safety and necessary of antiplatelet therapy for TBAD treated with EVAR combined with CHD using end points such as hemorrhage, endoleak, recurrent dissection, death, myocardial infarction, and cerebral infarction.
The present study indicated that long-term oral low-dose aspirin was safe for the patients with both TBAD and CHD who underwent EVAR.
A total of 118 TBAD inpatients (45 and 73 cases treated with OSR and TEVAR, respectively) who received professional treatment in Kaifeng Central Hospital during January 2004 to January 2015 were included in the retrospective study.
According to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines, the following criteria were applied to determine whether articles would qualify for the analysis: 1) studies comparing TBAD outcomes treated with TEVAR vs OSR and 2) the reported long-term results must contain survival rates or survival curves.
The general clinical characteristics and preoperative management of the patients with TBAD are shown in Table 1.
Endovascular repair, especially TEVAR, is a less invasive method for TBAD treatment and has been considered an important progress in surgery.
Hypertension may be the most common risk factor in patients with TBAD (23), and approximately 93.2% of the patients in this study were diagnosed with that disorder, implying that systemic vascular diseases may be associated with the pathogenesis of dissections.
Malperfusion syndrome is reported in approximately 10% of patients with acute TBAD and typically leads to paraparesis or paraplegia, lower limb ischemia, abdominal pain, nausea, and diarrhea (5).