Abstract：
BACKGROUND: This study aimed to assess geometry changes of the ascending aorta after thoracic endovascular aortic repair (TEVAR) for descending aortic dissection and identify potential risk factors for diameter and length change.
METHODS: Between April 2009 and July 2021, 102 patients were treated for acute descending aortic dissections (type B and non-A non-B) with TEVAR and were included in this analysis. Computed tomography angiographic scans were transferred to a dedicated imaging software and detailed aortic measurements (including length, diameter and area) were taken in multiplanar reconstruction postoperatively, after 6 months and annually thereafter.
RESULTS: Sixty-five (58%) patients were male, with a mean age of 66 (±11). Four (4%) patients were diagnosed with connective tissue disease. Before TEVAR, 79% of our patients were treated with a mean of 1.5 (±1.2) different classes of antihypertensive medications. This number rose to 98% after TEVAR and 2.7 (±1.0) different antihypertensive drugs. There was no significant change in length, diameter, cross-sectional area, or volume of the ascending aorta during the follow-up of 3 years after TEVAR. Body height was a negative predictor for mean ascending aortic diameter (P value = -0.013; B = -8.890) and mean aortic diameter at the level of the brachiocephalic trunk (P value = 0.039; B = -14.763).
CONCLUSIONS: Our data suggest no significant changes in the ascending aorta following TEVAR of the descending thoracic aorta during mid-term follow-up when under stringent blood pressure medication. Additionally, we did not find any modifiable risk factors for geometry parameter increase.
METHODS: Between April 2009 and July 2021, 102 patients were treated for acute descending aortic dissections (type B and non-A non-B) with TEVAR and were included in this analysis. Computed tomography angiographic scans were transferred to a dedicated imaging software and detailed aortic measurements (including length, diameter and area) were taken in multiplanar reconstruction postoperatively, after 6 months and annually thereafter.
RESULTS: Sixty-five (58%) patients were male, with a mean age of 66 (±11). Four (4%) patients were diagnosed with connective tissue disease. Before TEVAR, 79% of our patients were treated with a mean of 1.5 (±1.2) different classes of antihypertensive medications. This number rose to 98% after TEVAR and 2.7 (±1.0) different antihypertensive drugs. There was no significant change in length, diameter, cross-sectional area, or volume of the ascending aorta during the follow-up of 3 years after TEVAR. Body height was a negative predictor for mean ascending aortic diameter (P value = -0.013; B = -8.890) and mean aortic diameter at the level of the brachiocephalic trunk (P value = 0.039; B = -14.763).
CONCLUSIONS: Our data suggest no significant changes in the ascending aorta following TEVAR of the descending thoracic aorta during mid-term follow-up when under stringent blood pressure medication. Additionally, we did not find any modifiable risk factors for geometry parameter increase.
摘要：
目的：本研究旨在评估胸主动脉腔内修复术（TEVAR）治疗降主动脉夹层后升主动脉的几何结构变化，并确定直径和长度变化的潜在危险因素。
方法：2009年4月至2021年7月7日，102例急性降主动脉夹层（B型和非A型非B型）患者接受TEVAR治疗，并纳入本分析。计算机断层扫描血管造影扫描被转移到专用的成像软件和详细的主动脉测量（包括长度，直径和面积)在术后进行多平面重建，六个月后，每年。
结果：65（58％）患者为男性，平均年龄66（±11）岁。四名（4％）患者被诊断为结缔组织疾病。在TEVAR之前,79％的患者平均接受了1.5（±1.2）种不同类别的抗高血压药物治疗。TEVAR和2.7（±1.0）种不同的抗高血压药物后，这一数字上升到98％。长度没有明显变化，直径,横截面积,在TEVAR后3年的随访期间，升主动脉的体积或升主动脉的体积。身高是平均升主动脉直径（p值=-0.013；B=-8.890）和头臂干水平的平均主动脉直径（p值=0.039；B=-14.763）的负预测指标。
结论：我们的数据表明，在严格的血压药物治疗下，中期随访期间，TEVAR下行胸主动脉的升主动脉没有明显变化。此外,我们没有发现几何参数增加的任何可改变的危险因素.
方法：2009年4月至2021年7月7日，102例急性降主动脉夹层（B型和非A型非B型）患者接受TEVAR治疗，并纳入本分析。计算机断层扫描血管造影扫描被转移到专用的成像软件和详细的主动脉测量（包括长度，直径和面积)在术后进行多平面重建，六个月后，每年。
结果：65（58％）患者为男性，平均年龄66（±11）岁。四名（4％）患者被诊断为结缔组织疾病。在TEVAR之前,79％的患者平均接受了1.5（±1.2）种不同类别的抗高血压药物治疗。TEVAR和2.7（±1.0）种不同的抗高血压药物后，这一数字上升到98％。长度没有明显变化，直径,横截面积,在TEVAR后3年的随访期间，升主动脉的体积或升主动脉的体积。身高是平均升主动脉直径（p值=-0.013；B=-8.890）和头臂干水平的平均主动脉直径（p值=0.039；B=-14.763）的负预测指标。
结论：我们的数据表明，在严格的血压药物治疗下，中期随访期间，TEVAR下行胸主动脉的升主动脉没有明显变化。此外,我们没有发现几何参数增加的任何可改变的危险因素.
